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General NPI Number Information
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NPI Number | 1194806794
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Entity Type | Organization
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Legal Business Name | FAMILY RESTORATION SERVICES, LLC.
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1202 OAK ST
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City | RICHMOND
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State | VA
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Zip | 23220-2316
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Country | US
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Telephone | 804-775-0087
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Fax | 804-775-0119
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Provider Business Mailing Address
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Address Line | PO BOX 15293
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City | RICHMOND
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State | VA
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Zip | 23227-0693
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Country | US
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Telephone | 804-775-0087
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Fax | 804-775-0119
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. ZAKIA COPELAND
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Credential |
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Telephone | 804-775-0087
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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 | 83805001
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License Number State | VA
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