Annzetta's Therapeutic Home for Boys, LLC
NPI #1063609659 in Petersburg, Virginia
Provider Information
- NPI Number
- 1063609659
- Entity Type
- Organization
- Organization Name
- Annzetta's Therapeutic Home for Boys, LLC
- Primary Specialty
- Community Based Residential Treatment Facility, Mental Illness
- Enumeration Date
- Sep 27, 2007
- Last Updated
- Oct 25, 2007
Practice Location
- Address
- 1834 BUCKNER ST
- City
- Petersburg
- State
- Virginia
- ZIP Code
- 23805-1705
- Phone
- (804) 863-2661
Authorized Official
- Name
- MARY EMMA HARRIS
- Title
- OFFICE CLERK
- Phone
- (804) 861-5182
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Mental Illness |
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