Simple Intervention, Llc | |
9850 Lori Rd Suite 101 Chesterfield VA 23832-6758 | |
(804) 621-4034 | |
(804) 621-4091 |
Full Name | Simple Intervention, Llc |
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Speciality | Community/behavioral Health |
Location | 9850 Lori Rd, Chesterfield, Virginia |
Authorized Official Name and Position | Brandon C Hudson (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 8046214034 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Simple Intervention, Llc Po Box 1330 Chesterfield VA 23832-9103 Ph: (804) 621-4034 | Simple Intervention, Llc 9850 Lori Rd Suite 101 Chesterfield VA 23832-6758 Ph: (804) 621-4034 |
NPI Number | 1043612104 |
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Provider Enumeration Date | 09/20/2014 |
Last Update Date | 02/06/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043612104 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 2548 (Virginia) | Primary |
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