Healthcare Provider Details

I. General information

NPI: 1992959928
Provider Name (Legal Business Name): ST. JOSEPH'S VILLA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2008
Last Update Date: 11/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 BROOK RD
RICHMOND VA
23227-1306
US

IV. Provider business mailing address

8000 BROOK RD
RICHMOND VA
23227-1306
US

V. Phone/Fax

Practice location:
  • Phone: 804-553-3200
  • Fax: 804-553-3259
Mailing address:
  • Phone: 804-553-3200
  • Fax: 804-553-3259

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: MS. CYNTHIA LYNN FAISON
Title or Position: CHIEF OPERATIONS OFFICER
Credential: M.S.
Phone: 804-553-3249