MEDICARE: WEST LAKE RESIDENTIAL FACILITY

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	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	0459	VA

General Provider Information

NPI Number	:	1225178312
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST LAKE RESIDENTIAL FACILITY

Provider Business Mailing Address
First Line	:	PO BOX 4506
Second Line	:
City	:	MIDLOTHIAN
State	:	VA
Zip	:	23112
Country	:	US
Telephone Number	:	804-560-9774
Fax Number	:	804-560-9776

Provider Business Practice Location Address
First Line	:	6946 FOREST HILL AVE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23225-1606
Country	:	US
Telephone Number	:	804-560-9774
Fax Number	:	804-560-9776

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JIMMIE JUNIOR PRATT
Credential	:
Telephone Number	:	804-560-9774

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	08/22/2020

Similar Medicare Providers

1770532475 — MRS. AMY M. THOMAS-HARMON LCSW
Practice Location Address:

6962 FOREST HILL AVE
RICHMOND, VA
23225-1606

Practice Phone: 804-519-0016
Practice Fax:

1740402551 — JAY A. MAYNARD L.P.C.
Practice Location Address:

6962 FOREST HILL AVE
RICHMOND, VA
23225-1606

Practice Phone: 804-320-7738
Practice Fax: 804-320-8738

1356518344 — MR. TOBY ANDERSON LCSW
Practice Location Address:

6962 FOREST HILL AVE
RICHMOND, VA
23225-1606

Practice Phone: 804-381-9449
Practice Fax: 804-320-8738

1710125885 — ALLIANCE FOR SENIORS, INC.
Practice Location Address:

6966B FOREST HILL AVE
RICHMOND, VA
23225-1606

Practice Phone: 804-323-6900
Practice Fax: 804-323-9616

1992931752 — JANICE TOOLE
Practice Location Address:

6962 FOREST HILL AVE
RICHMOND, VA
23225-1606

Practice Phone: 804-320-7738
Practice Fax: 804-320-8738

1316244510 — MRS. LEKEISHA SHENNILLE HITE LPC, CSAC
Practice Location Address:

6946 FOREST HILL AVE
RICHMOND, VA
23225-1606

Practice Phone: 804-560-8882
Practice Fax: 804-560-8884

Directions to “WEST LAKE RESIDENTIAL FACILITY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.