MEDICARE: COORDINATORS2INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253J00000X	Foster Care Agency	CPA16	VA

General Provider Information

NPI Number	:	1366859050
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COORDINATORS2INC

Provider Business Mailing Address
First Line	:	8100 THREE CHOPT RD
Second Line	:	SUITE 101
City	:	RICHMOND
State	:	VA
Zip	:	23229-4833
Country	:	US
Telephone Number	:	804-354-1881
Fax Number	:	804-355-1001

Provider Business Practice Location Address
First Line	:	8100 THREE CHOPT RD
Second Line	:	SUITE 101
City	:	RICHMOND
State	:	VA
Zip	:	23229-4833
Country	:	US
Telephone Number	:	804-354-1881
Fax Number	:	804-355-1001

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. REBECCA RICARDO
Credential	:	LCSW
Telephone Number	:	804-354-1881

Provider Enumeration Date	:	07/15/2014
Last Update Date	:	07/15/2014

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