Organization · NPI-2

Upside To Youth Development L.L.C.

Community/Behavioral Health · Chesterfield, VA

NPI number1982804308

StatusActive

Last updated in NPPESMar 21, 2023

Details

NPI: 1982804308
Entity type: Organization (NPI-2)
Legal business name: Upside To Youth Development L.L.C.
Organization subpart: No
Enumeration date: Jul 23, 2007
Certification date: Mar 21, 2023
Last updated: Mar 21, 2023

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
251S00000X	Community/Behavioral Health	–	–	Yes
251B00000X	Case Management	–	–
261QM2800X	Clinic/Center, Methadone Clinic	–	–
320600000X	Residential Treatment Facility, Intellectual and/or Developmental Disabilities	–	–
320800000X	Community Based Residential Treatment Facility, Mental Illness	–	–
323P00000X	Psychiatric Residential Treatment Facility	–	–

Practice location

9401 Courthouse Rd Ste 300
Chesterfield, VA 23832-6686

Phone 804-205-1011 · Fax 804-479-8175

Mailing address

9401 Courthouse Rd Ste 300
Chesterfield, VA 23832-6686

Phone 804-205-1011 · Fax 804-479-8175

Other practice locations

12810 Hillcrest Rd Ste B221
Dallas, TX 75230-1525

Phone 804-943-0629

Authorized official

Robert Edward Gay
Chief Executive Officer
8049430629

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