49D2176824 CLIA NUMBER - SOUTHSIDE BEHAVIORAL HEALTH

Laboratory Demographics

CLIA Number: 49D2176824

Facility Name: SOUTHSIDE BEHAVIORAL HEALTH

Facility Address:
424 HAMILTON BLVD
SOUTH BOSTON, VA
ZIP 24592
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Facility Phone Number: 434 572-6916

Facility Type: Other - BEHAVIORAL HEALTH CLINIC

Certificate Type: Waiver

NPI Number: 1700890761

Taxonomy: 251S00000X - Community/Behavioral Health
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

CLIA Record

Field Name	Field Value
CLIA Number	49D2176824
LAB Type	Other - BEHAVIORAL HEALTH CLINIC
Facility Name	SOUTHSIDE BEHAVIORAL HEALTH
Street	424 HAMILTON BLVD
City	SOUTH BOSTON
State	VA
ZIP	24592
Phone	434 572-6916
CertificateType	4
CertificateEffectiveDate	12/26/2023
CertificateExpirationDate	12/25/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024