ANNZETTA'S THERAPEUTIC HOME FOR BOYS, LLC
NPI 1063609659
Community Based Residential Treatment Facility, Mental Illness in Petersburg, VA
About Annzetta's Therapeutic Home For Boys, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANNZETTA'S THERAPEUTIC HOME FOR BOYS, LLC (NPI 1063609659) is a healthcare organization registered as a community based residential treatment facility, mental illness in Petersburg, Virginia and active in the NPI registry since September 2007. The organization lists Mary Emma Harris, Office Clerk, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Annzetta's Therapeutic Home For Boys, LLC's NPI number?
The NPI number for Annzetta's Therapeutic Home For Boys, LLC is 1063609659. It was assigned to this organization in the NPPES registry on September 27, 2007.
Where is Annzetta's Therapeutic Home For Boys, LLC located?
Annzetta's Therapeutic Home For Boys, LLC is located at 1834 Buckner St, Petersburg, VA 23805. The listed phone number is (804) 863-2661.
What is Annzetta's Therapeutic Home For Boys, LLC's specialty?
The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Mental Illness with taxonomy code 320800000X.
When was this NPI record last updated?
The NPPES record for Annzetta's Therapeutic Home For Boys, LLC was last updated on October 25, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Annzetta's Therapeutic Home For Boys, Llc · NPI 1063609659
Community Based Residential Treatment Facility, Mental Illness organization in Petersburg, Virginia. Organization record, active in the CMS NPPES registry since September 27, 2007.
## Identity
- **NPI:** 1063609659 (Entity type: Organization)
- **Enumerated:** September 27, 2007
- **Primary specialty:** Community Based Residential Treatment Facility, Mental Illness · taxonomy 320800000X
- **Organization subpart:** No
- **Authorized official:** Mary Harris, OFFICE CLERK
## Practice location
- **Address:** 1834 BUCKNER ST, Petersburg, VA 23805-1705
- **Phone:** (804) 863-2661
## Record status
- **NPPES last updated:** October 25, 2007
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Source: [NPI Profile](https://npiprofile.com/npi/1063609659) · Data from the CMS NPPES public registry.