Provider First Line Business Practice Location Address:
THE PINES RESIDENTAL TREATMENT CENTER
Provider Second Line Business Practice Location Address:
301 FORT LANE
Provider Business Practice Location Address City Name:
PORTSMOUTH
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23704
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-391-6562
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/27/2006