=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548421977
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | S.T.O.N.E.S, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/18/2008
-----------------------------------------------------
Last Update Date | 06/18/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9030 THREE CHOPT RD SUITE D
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23229-4641
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-677-9326
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9030 THREE CHOPT RD SUITE D
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23229-4641
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-677-9326
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR OF FINANCE
-----------------------------------------------------
Name | MRS. RICKETA C REED
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 804-677-9326
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number | 1064
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------