| Holston Um Home For Children | |
|
300 Moore St Ste A Bristol VA 24201-4337 | |
| (276) 591-5301 | |
| (276) 591-5304 |
| Full Name | Holston Um Home For Children |
|---|---|
| Speciality | Counselor |
| Location | 300 Moore St Ste A, Bristol, Virginia |
| Authorized Official Name and Position | Dianna Wilson (DIRECTOR) |
| Authorized Official Contact | 2765915301 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Holston Um Home For Children 300 Moore St Ste A Bristol VA 24201-4337 Ph: (276) 591-5301 | Holston Um Home For Children 300 Moore St Ste A Bristol VA 24201-4337 Ph: (276) 591-5301 |
| NPI Number | 1669578886 |
|---|---|
| Provider Enumeration Date | 09/15/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669578886 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 569 (Virginia) | Primary |
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