DOMINION YOUTH SERVICES RESIDENTIAL – NPI #1952562811
Community Based Residential Treatment Facility, Mental Illness

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

DOMINION YOUTH SERVICES RESIDENTIAL is a community based residential treatment facility located in ROANOKE, VA. NPPES has assigned the NPI number 1952562811 to DOMINION YOUTH SERVICES RESIDENTIAL on June 23, 2008. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “DOMINION YOUTH SERVICES RESIDENTIAL” is a dba name, the actual legal business name for this organization is DOMINION YOUTH SERVICES. The primary taxonomy selected by this provider is 320800000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Mental Illness.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for DOMINION YOUTH SERVICES RESIDENTIAL below.

NPI Profile for
DOMINION YOUTH SERVICES

NPI Number
1952562811
Enumeration Date

(about 18 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
DOMINION YOUTH SERVICES
Doing Business As (dba): DOMINION YOUTH SERVICES RESIDENTIAL
Primary location
4802 NORTHRIDGE LANE
ROANOKE, VA 24019
Phone: (540) 366-3080 Fax: (540) 366-3081
Mailing address
8401 MAYLAND DRIVE
SUITE C
RICHMOND, VA 23294
Phone: (804) 285-9838 Fax: (804) 285-9839
Organization Subpart
No
Authorized Official
GL PULLIAM
DIRECTOR OF RESIDENTIAL
Phone: (804) 285-9838
Updated
Identifiers

Identifiers for DOMINION YOUTH SERVICES RESIDENTIAL

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERDMH LICENSEVA406-14-077
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320800000X
- Community Based Residential Treatment Facility, Mental Illness (Primary)
VA 40614077

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.