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General NPI Number Information
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NPI Number | 1437041993
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Entity Type | Organization
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Legal Business Name | BLUE HOUSE RVA
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Dates
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Enumeration Date | 07/18/2025
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 7800 MILLCREEK DR
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23235-6742
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Country | US
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Telephone | 980-829-9688
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Fax |
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Provider Business Mailing Address
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Address Line | 2406 CASCADE MEADOWS DR
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-4292
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Country | US
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Telephone | 980-829-9688
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | NATALIA BARRANTES
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Credential |
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Telephone | 980-829-9688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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