Healthcare Provider Details
I. General information
NPI: 1356562011
Provider Name (Legal Business Name): PREVENT CHILD ABUSE VIRGINIA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/01/2007
Last Update Date: 03/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8100 THREE CHOPT RD RM 212
RICHMOND VA
23229-4800
US
IV. Provider business mailing address
8100 THREE CHOPT RD RM 212
RICHMOND VA
23229-4800
US
V. Phone/Fax
- Phone: 804-783-2667
- Fax: 804-783-2723
- Phone: 804-783-2667
- Fax: 804-783-2723
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
LAURA
M
DARLING
Title or Position: COO
Credential: MPA
Phone: 804-332-6550