Healthcare Provider Details

I. General information

NPI: 1144516923
Provider Name (Legal Business Name): HALLMARK YOUTHCARE-RICHMOND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2011
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12800 W CREEK PKWY
RICHMOND VA
23238-1116
US

IV. Provider business mailing address

12800 W CREEK PKWY
RICHMOND VA
23238-1116
US

V. Phone/Fax

Practice location:
  • Phone: 804-980-7530
  • Fax:
Mailing address:
  • Phone: 804-784-2200
  • Fax: 804-784-5331

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 StateVA
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VERONICA BRATTON
Title or Position: CREDENTIALING
Credential:
Phone: 804-497-6889