Healthcare Provider Details

I. General information

NPI: 1700022506
Provider Name (Legal Business Name): COALITION OF YOUTH EMPOWERMENT INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2008
Last Update Date: 12/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E.A. TURNER RD
RICHMOND VA
27589-8931
US

IV. Provider business mailing address

600 E.A. TURNER RD
RICHMOND VA
27589-8931
US

V. Phone/Fax

Practice location:
  • Phone: 804-677-0430
  • Fax:
Mailing address:
  • Phone: 804-677-0430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. CAMILLE YVETTE PARHAM
Title or Position: CEO
Credential: MHS
Phone: 804-677-0430