| Youth And Family Dynamics In-home Services,llc | |
|
5741 South Laburnum Avenue Henrico VA 23231-4726 | |
| (804) 501-9440 | |
| Not Available |
| Full Name | Youth And Family Dynamics In-home Services,llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5741 South Laburnum Avenue, Henrico, Virginia |
| Authorized Official Name and Position | Allen Fitzgerald Jackson (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8045019440 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Youth And Family Dynamics In-home Services,llc 1733 First Colonial Court Henrico VA 23231-4726 Ph: (804) 501-9440 | Youth And Family Dynamics In-home Services,llc 5741 South Laburnum Avenue Henrico VA 23231-4726 Ph: (804) 501-9440 |
| NPI Number | 1346499233 |
|---|---|
| Provider Enumeration Date | 09/16/2008 |
| Last Update Date | 03/28/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346499233 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | S242537-1 (Virginia) | Primary |
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