Healthcare Provider Details

I. General information

NPI: 1407767932
Provider Name (Legal Business Name): KAIZEN HEALTH VIRGINIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 N ROBINSON ST STE 403
RICHMOND VA
23220-4462
US

IV. Provider business mailing address

5 PARK PLZ STE 1520
IRVINE CA
92614-2566
US

V. Phone/Fax

Practice location:
  • Phone: 949-933-6412
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MR. JACK BIEHL
Title or Position: CEO
Credential:
Phone: 949-933-6412