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General NPI Number Information
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NPI Number | 1740347145
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Entity Type | Organization
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Legal Business Name | BEHAVIORAL AWARENESS CENTER, PC
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 08/06/2010
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Provider Practice Location Address
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Address Line | 681 HIOAKS RD SUITE A
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City | RICHMOND
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State | VA
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Zip | 23225-4043
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Country | US
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Telephone | 804-320-3626
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Fax | 804-330-5567
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Provider Business Mailing Address
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Address Line | 681 HIOAKS ROAD SUITE A
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City | RICHMOND
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State | VA
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Zip | 23225
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Country | US
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Telephone | 804-320-3626
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Fax | 804-330-5567
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. LAUREL V. PURCHASE
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Credential | LCSW
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Telephone | 804-320-3626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 0904001006
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License Number State | VA
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