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General NPI Number Information
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NPI Number | 1912385642
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Entity Type | Organization
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Legal Business Name | HENRICO COUNTY
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Dates
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Enumeration Date | 05/14/2015
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Last Update Date | 05/14/2015
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Provider Practice Location Address
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Address Line | 10299 WOODMAN RD
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City | GLEN ALLEN
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State | VA
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Zip | 23060-4419
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Country | US
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Telephone | 804-727-8500
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Fax | 804-727-8580
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Provider Business Mailing Address
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Address Line | 10299 WOODMAN RD
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City | GLEN ALLEN
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State | VA
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Zip | 23060-4419
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Country | US
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Telephone | 804-727-8500
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Fax | 804-727-8580
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. LAURA S. TOTTY
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Credential |
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Telephone | 804-727-8585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 099
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License Number State | VA
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