Citty INC.
Community Based Residential Treatment Facility, Mental Illness in Highland Springs, VA. Organization (NPI-2).
NPI number1184809287
StatusActive
Last updated in NPPESJan 8, 2008
Details
- NPI
- 1184809287
- Entity type
- Organization (NPI-2)
- Legal business name
- Citty INC.
- Organization subpart
- No
- Enumeration date
- Jan 8, 2008
- Last updated
- Jan 8, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320800000X | Community Based Residential Treatment Facility, Mental Illness | SS-343-07 | VA | Yes |
Other names
- Opportunity Center (Doing Business As)
Practice location
177 Elsing Green WayHighland Springs, VA 23075-2451
Phone 804-218-0935
Mailing address
177 Elsing Green WayHighland Springs, VA 23075-2451
Phone 804-218-0935
Authorized official
Michael Jermaine Jackson
Cao/Program Director
8042180935
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