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General NPI Number Information
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NPI Number | 1124225933
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Entity Type | Organization
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Legal Business Name | FAMILY AND ADOLESCENT SERVICES. LLC
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Dates
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Enumeration Date | 06/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 501 E FRANKLIN ST SUITE 724
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City | RICHMOND
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State | VA
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Zip | 23219-2322
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Country | US
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Telephone | 804-521-4050
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Fax |
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Provider Business Mailing Address
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Address Line | 501 E FRANKLIN ST SUITE 724
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City | RICHMOND
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State | VA
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Zip | 23219-2322
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Country | US
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Telephone | 804-521-4050
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Fax |
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Authorized Official
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Title or Position | C. E. O.
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Name | DR. LAWRENCE EUGENE WOODSON
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Credential |
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Telephone | 804-520-4050
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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 | 071011358350
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License Number State | VA
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