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General NPI Number Information
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NPI Number | 1518788421
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Entity Type | Organization
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Legal Business Name | KALEIDOSCOPE SOLUTIONS LLC
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Dates
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Enumeration Date | 10/23/2024
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 2111 MILLER AVE
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City | RICHMOND
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State | VA
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Zip | 23222-4339
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Country | US
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Telephone | 804-299-5590
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Fax |
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Provider Business Mailing Address
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Address Line | 7330 STAPLES MILL RD STE 285
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City | RICHMOND
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State | VA
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Zip | 23228-4122
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Country | US
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Telephone | 804-299-5590
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. LOIS WALTERS-THREAT
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Credential | DNP, APRN, PMHNP-BC
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Telephone | 804-299-5590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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