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General NPI Number Information
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NPI Number | 1740586106
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Entity Type | Organization
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Legal Business Name | THE FAISON CENTER, INC
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Dates
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Enumeration Date | 02/02/2011
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 5311 MARKEL RD
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City | RICHMOND
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State | VA
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Zip | 23230-3008
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Country | US
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Telephone | 804-612-1947
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Fax | 804-612-1955
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Provider Business Mailing Address
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Address Line | 5311 MARKEL RD
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City | RICHMOND
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State | VA
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Zip | 23230-3008
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Country | US
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Telephone | 804-612-1947
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Fax | 804-612-1955
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | JESSICA SHADE
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Credential |
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Telephone | 804-612-1947
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number | 1726-07-010
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 1726-02-010
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1726-07-010
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License Number State | VA
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