Healthcare Provider Details

I. General information

NPI: 1184570855
Provider Name (Legal Business Name): EMBER INITIATIVES COMMUNITY SERVICES AND WELLNESS SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8012 SYCAMORE LN
HENRICO VA
23228-3731
US

IV. Provider business mailing address

8012 SYCAMORE LN
HENRICO VA
23228-3731
US

V. Phone/Fax

Practice location:
  • Phone: 804-678-8235
  • Fax:
Mailing address:
  • Phone: 804-678-8235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. BRADLEY DAVID CALHOUN
Title or Position: OWNER
Credential:
Phone: 804-678-8235