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General NPI Number Information
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NPI Number | 1073357505
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Entity Type | Organization
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Legal Business Name | FAVORED SERVICES, LLC
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Dates
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Enumeration Date | 06/20/2024
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Last Update Date | 06/20/2024
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Provider Practice Location Address
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Address Line | 2250 MURRELL RD
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City | LYNCHBURG
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State | VA
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Zip | 24501-2141
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Country | US
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Telephone | 434-444-9902
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Fax | 434-849-7665
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Provider Business Mailing Address
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Address Line | 107 CRESTLINE DR
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City | FOREST
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State | VA
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Zip | 24551-1470
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Country | US
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Telephone | 434-851-8657
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MR. OLAMIDE TOKUNBO KEHINDE
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Credential | QMHP
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Telephone | 434-444-9902
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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