| Full Potential Youth Services | |
|
18 Taylor Rd Richmond VA 23223-5532 | |
| (804) 222-3510 | |
| Not Available |
| Full Name | Full Potential Youth Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 18 Taylor Rd, Richmond, Virginia |
| Authorized Official Name and Position | James Broadnax Harris (CHIEF ADMINISTRATION OFFICER) |
| Authorized Official Contact | 8048374492 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Full Potential Youth Services 13107 Liberty Point Pl Midlothian VA 23112-7000 Ph: (804) 222-3510 | Full Potential Youth Services 18 Taylor Rd Richmond VA 23223-5532 Ph: (804) 222-3510 |
| NPI Number | 1366628760 |
|---|---|
| Provider Enumeration Date | 01/15/2008 |
| Last Update Date | 01/15/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366628760 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | SS36507 (Virginia) | Primary |
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