MEDICARE: GUIDING YOUNG MINDS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320800000X	Mental Illness Community Based Residential Treatment Facility	SS-273-05	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124295530
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUIDING YOUNG MINDS LLC

Provider Business Mailing Address
First Line	:	129 WILKINSON ESTATES DR
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23227-2128
Country	:	US
Telephone Number	:	804-658-3643
Fax Number	:

Provider Business Practice Location Address
First Line	:	526 DABBS HOUSE RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23223-2604
Country	:	US
Telephone Number	:	804-264-8214
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. SILVANUS N. THROWER
Credential	:
Telephone Number	:	804-647-1792

Provider Enumeration Date	:	05/14/2008
Last Update Date	:	05/20/2008

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Directions to “GUIDING YOUNG MINDS LLC ” Practice Location

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