Healthcare Provider Details

I. General information

NPI: 1952755597
Provider Name (Legal Business Name): 180 DEGREE SUPPORT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2016
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4914 RADFORD AVENUE SUITE 308-A
RICHMOND VA
23230-3538
US

IV. Provider business mailing address

4914 RADFORD AVENUE SUITE 308-A AND 305
RICHMOND VA
23230
US

V. Phone/Fax

Practice location:
  • Phone: 804-475-6979
  • Fax:
Mailing address:
  • Phone: 804-475-6979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number212003001
License Number StateVA

VIII. Authorized Official

Name: DOUGLAS HOOD
Title or Position: CEO
Credential:
Phone: 804-475-6979