Healthcare Provider Details

I. General information

NPI: 1801703939
Provider Name (Legal Business Name): FAMILY AND ADOLESCENT SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3623 SAUNDERS AVE
RICHMOND VA
23227-4354
US

IV. Provider business mailing address

3623 SAUNDERS AVE
RICHMOND VA
23227-4354
US

V. Phone/Fax

Practice location:
  • Phone: 504-521-4050
  • Fax: 804-521-4048
Mailing address:
  • Phone: 804-521-4050
  • Fax: 804-521-4048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DR. MARCIA FAYE HATHAWAY
Title or Position: COMMUNITY OUTREACH SERVICES COORDIN
Credential:
Phone: 804-521-4050