Healthcare Provider Details

I. General information

NPI: 1700019148
Provider Name (Legal Business Name): PUT FAMILY FIRST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2009
Last Update Date: 09/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5516 FALMOUTH ST 103
RICHMOND VA
23230-1819
US

IV. Provider business mailing address

5516 FALMOUTH ST 103
RICHMOND VA
23230-1819
US

V. Phone/Fax

Practice location:
  • Phone: 804-658-4626
  • Fax:
Mailing address:
  • Phone: 804-658-4626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: FRANCHETTE REBBECCA MAY
Title or Position: PROGRAM DIRECTOR
Credential: BA
Phone: 804-658-4626