Healthcare Provider Details

I. General information

NPI: 1437487345
Provider Name (Legal Business Name): ALC YOUTH & FAMILY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2009
Last Update Date: 12/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9831 KEVKEN DR
RICHMOND VA
23237-4058
US

IV. Provider business mailing address

1313 PLEASANT CREEK CT
COLONIAL HEIGHTS VA
23834-6841
US

V. Phone/Fax

Practice location:
  • Phone: 804-651-7972
  • Fax: 804-530-0195
Mailing address:
  • Phone: 804-651-7972
  • Fax: 804-530-0195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. RODNEY MARK WILLIAMS
Title or Position: MANAGING MEMBER
Credential:
Phone: 804-651-7972