Organization Name: | DISTRICT 19 COMMUNITY SERVICE BOARD |
NPI Number: | 1013283738 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSEPH HUBBARD (EXECUTIVE DIRECTOR) |
Mailing Address: | 20 W Bank St Suite 7 Petersburg |
State: | VA US |
Postal Code: | 238033279 |
Phone Number: | 8048628054 |
Fax Number: | |
NPI Enumeration Date: | 03/27/2012 |
NPI Last Update Date: | 03/27/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0850X |
License Number: | 0001122835 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Adult Mental Health |
Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |