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General NPI Number Information
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NPI Number | 1659812022
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Entity Type | Organization
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Legal Business Name | DEVELOPMENTAL AND BEHAVIORAL SERVICES OF VIRGINIA
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Dates
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Enumeration Date | 03/17/2017
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Last Update Date | 03/17/2017
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Provider Practice Location Address
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Address Line | 619 N 37TH ST
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City | RICHMOND
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State | VA
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Zip | 23223-8101
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Country | US
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Telephone | 804-519-4448
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Fax |
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Provider Business Mailing Address
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Address Line | 619 N 37TH ST
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City | RICHMOND
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State | VA
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Zip | 23223-8101
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Country | US
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Telephone | 804-519-4448
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHERODNICKER TAMAR BROWN
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Credential |
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Telephone | 804-519-4448
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | RBT1506136
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License Number State | VA
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