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General NPI Number Information
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NPI Number | 1932241130
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Entity Type | Organization
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Legal Business Name | COMMUNITY EMPOWERMENT SERVICES
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 12/09/2008
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Provider Practice Location Address
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Address Line | 5803 NINE MILE RD
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City | RICHMOND
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State | VA
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Zip | 23223-3429
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Country | US
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Telephone | 804-614-6086
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Fax | 757-299-9894
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Provider Business Mailing Address
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Address Line | 3404 HOLLOW RIDGE CT
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City | CHESTERFIELD
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State | VA
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Zip | 23832-8560
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Country | US
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Telephone | 804-614-6086
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DAMON L PRATT
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Credential | LCSW
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Telephone | 804-614-6086
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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 | 0904006485
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License Number State | VA
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