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1013210178
YOUTH AND FAMILY DYNAMICS MENTAL HEALTH SUPPORT, LLC
HENRICO, VA
NPI
1013210178
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Entity Type
Organization
Authorized Contact
ALLEN F. JACKSON
Cheif Executive Officer
804-477-3065
Organization Subpart ?
No
Primary Taxonomy
251S00000X
(Licence: VA 1162)
Enumeration Date
2010-12-13
Last Update Date
2013-12-03
Business Address
YOUTH AND FAMILY DYNAMICS MENTAL HEALTH SUPPORT, LLC
5741 S LABURNUM AVE SUITE #111
HENRICO, VA 23231-4431
Phone number: 804-477-3065
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Mailing Address
YOUTH AND FAMILY DYNAMICS MENTAL HEALTH SUPPORT, LLC
1733 FIRST COLONIAL CT
HENRICO, VA 23231-6892
Phone number: 804-501-9440
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