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Dominion Youth Services
Mental Illness Community Based Residential Treatment Facility in Roanoke, Virginia
NPI 1952562811

Dominion Youth Services is a Mental Illness Community Based Residential Treatment Facility based in Richmond, VA. Dominion Youth Services practices in Roanoke, VA. The NPI Number for Dominion Youth Services is 1952562811 and holds a License No. 40614077 (Virginia).

The current practice location address for Dominion Youth Services is 4802 Northridge Lane, Roanoke, VA and can be reached out via phone at 540-366-3080 and via fax at 540-366-3081.

Location: 4802 Northridge Lane, Roanoke, VA, 23294
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1952562811
Provider Name
Dominion Youth Services
Credential
Provider Entity Type
Organization
Address
4802 Northridge Lane, Roanoke, VA, 23294
Phone Number
540-366-3080
Fax Number
540-366-3081
Provider Enumeration Date
06/23/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
406-14-077 01 VA DMH LICENSE
institution
Provider Business Practice Location Address Details
Address
4802 Northridge Lane
City
Roanoke
State
Virginia
Zip
24019
Phone Number
540-366-3080
Fax Number
540-366-3081
person
Provider Business Mailing Address Details
Address
4802 Northridge Lane
City
Roanoke
State
Virginia
Zip
24019
Phone Number
540-366-3080
Fax Number
540-366-3081
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Mental Illness
Speciality
-
Taxonomy
320800000X
License No.
40614077 (Virginia)
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
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