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General NPI Number Information
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NPI Number | 1427419035
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Entity Type | Organization
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Legal Business Name | POWERHOUSE UNLIMITED
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Dates
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Enumeration Date | 03/09/2016
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Last Update Date | 11/14/2016
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Provider Practice Location Address
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Address Line | 418 N 25TH ST APT 260
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City | RICHMOND
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State | VA
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Zip | 23223-7564
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Country | US
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Telephone | 240-455-2085
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Fax |
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Provider Business Mailing Address
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Address Line | 418 N 25TH ST APT 260
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City | RICHMOND
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State | VA
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Zip | 23223
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Country | US
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Telephone | 240-455-2085
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Fax |
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Authorized Official
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Title or Position | CO-CEO
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Name | TAYLA RHINE
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Credential | M.S.
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Telephone | 240-455-2085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 322D00000X
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Taxonomy Name | Emotionally Disturbed Childrens' Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #3
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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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