Youth And Family Dynamics Day Treatment Support,llc | |
5741 S Laburnum Ave Henrico VA 23231-4431 | |
(804) 501-9440 | |
Not Available |
Full Name | Youth And Family Dynamics Day Treatment Support,llc |
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Speciality | Community/behavioral Health |
Location | 5741 S Laburnum Ave, Henrico, Virginia |
Authorized Official Name and Position | Allen F Jackson (CHEIF EXECUTIVE OFFICER/LLC) |
Authorized Official Contact | 8045019440 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Youth And Family Dynamics Day Treatment Support,llc 1733 First Colonial Ct Henrico VA 23231-6892 Ph: (804) 501-9440 | Youth And Family Dynamics Day Treatment Support,llc 5741 S Laburnum Ave Henrico VA 23231-4431 Ph: (804) 501-9440 |
NPI Number | 1467781799 |
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Provider Enumeration Date | 12/16/2009 |
Last Update Date | 12/03/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1467781799 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 1162-02-030 (Virginia) | Primary |
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