Youth And Family Dynamics Mental Health Support, LLC
Community/Behavioral Health in Henrico, VA. Organization (NPI-2).
NPI number1013210178
StatusActive
Last updated in NPPESDec 3, 2013
Details
- NPI
- 1013210178
- Entity type
- Organization (NPI-2)
- Legal business name
- Youth And Family Dynamics Mental Health Support, LLC
- Organization subpart
- No
- Enumeration date
- Dec 13, 2010
- Last updated
- Dec 3, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 251S00000X | Community/Behavioral Health | 1162 | VA | Yes |
Practice location
5741 S Laburnum AveSuite #111
Henrico, VA 23231-4431
Phone 804-477-3065 · Fax 804-477-3092
Mailing address
1733 First Colonial CtHenrico, VA 23231-6892
Phone 804-501-9440 · Fax 804-222-8122
Authorized official
Allen F. Jackson
Cheif Executive Officer
8044773065
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