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NPI Code Detail

MEDICARE: GENERATION X-CEL THERAPEUTIC DAY TREATMENT

MEDICARE: GENERATION X-CEL THERAPEUTIC DAY TREATMENT
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
1251S00000XCommunity/Behavioral Health Agency349-14-002VA

General Provider Information

NPI Number : 1295969145
Entity Type Code : Organization
Provider Name (Legal Business Name) : GENERATION X-CEL THERAPEUTIC DAY TREATMENT
Provider Business Mailing Address
First Line : 6481 IRON BRIDGE RD
Second Line :
City : RICHMOND
State : VA
Zip : 23234-5205
Country : US
Telephone Number : 804-279-8995
Fax Number :
Provider Business Practice Location Address
First Line : 6481 IRON BRIDGE RD
Second Line :
City : RICHMOND
State : VA
Zip : 23234-5205
Country : US
Telephone Number : 804-279-8995
Fax Number :
Authorized Official
Title or Position : CEO
Name : LAROME KENNEY
Credential :
Telephone Number : 804-279-8995
Provider Enumeration Date : 05/06/2009
Last Update Date : 05/07/2009

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Directions to “GENERATION X-CEL THERAPEUTIC DAY TREATMENT ” Practice Location

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