| Youth And Family Dynamics Mental Health Support, Llc | |
|
5741 S Laburnum Ave Suite #111 Henrico VA 23231-4431 | |
| (804) 477-3065 | |
| (804) 477-3092 |
| Full Name | Youth And Family Dynamics Mental Health Support, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5741 S Laburnum Ave, Henrico, Virginia |
| Authorized Official Name and Position | Allen F. Jackson (CHEIF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8044773065 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Youth And Family Dynamics Mental Health Support, Llc 1733 First Colonial Ct Henrico VA 23231-6892 Ph: (804) 501-9440 | Youth And Family Dynamics Mental Health Support, Llc 5741 S Laburnum Ave Suite #111 Henrico VA 23231-4431 Ph: (804) 477-3065 |
| NPI Number | 1013210178 |
|---|---|
| Provider Enumeration Date | 12/13/2010 |
| Last Update Date | 12/03/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013210178 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 1162 (Virginia) | Primary |
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