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General NPI Number Information
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NPI Number | 1407454515
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Entity Type | Organization
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Legal Business Name | ALWAYS BLOSSOM, LLC
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Dates
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Enumeration Date | 10/12/2020
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Last Update Date | 10/12/2020
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Provider Practice Location Address
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Address Line | 611 W GRAHAM RD
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City | RICHMOND
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State | VA
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Zip | 23222-4207
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Country | US
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Telephone | 180-433-7372
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Fax |
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Provider Business Mailing Address
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Address Line | 611 W GRAHAM RD
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City | RICHMOND
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State | VA
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Zip | 23222-4207
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Country | US
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Telephone | 180-433-7372
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CASSANDRA JONES
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Credential |
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Telephone | 804-337-3729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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