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14403 Michaels Ridge Rd Midlothian VA 23113-6327 | |
| (804) 245-0727 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 14403 Michaels Ridge Rd, Midlothian, Virginia |
| Authorized Official Name and Position | R.c. Carter (PRESIDENT) |
| Authorized Official Contact | 8047191966 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5001 W Village Green Dr Ste 100 Midlothian VA 23112-4801 Ph: (804) 719-1966 | 14403 Michaels Ridge Rd Midlothian VA 23113-6327 Ph: (804) 245-0727 |
| NPI Number | 1144753252 |
|---|---|
| Provider Enumeration Date | 04/05/2017 |
| Last Update Date | 04/28/2022 |
| Certification Date | 04/28/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144753252 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | T69801970 (Virginia) | Primary |
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