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Organization
ERVIN'S VILLAGE FAMILY SUPPORT LLC
Active
Organization
ERVIN'S VILLAGE FAMILY SUPPORT LLC
Active
Parent organization
ERVIN'S VILLAGE LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ERVIN'S VILLAGE LLC
Authorized official
JACQUESE HINTON (VP OF OPERATIONS)
(434) 713-9946
Entity
Organization
Contact information
Practice address
10 E CHURCH ST STE 505, MARTINSVILLE, VA 24112-6204
(434) 201-4911
(434) 888-8508
Mailing address
10 E CHURCH ST STE 505, MARTINSVILLE, VA 24112-6204
(434) 201-4911
(434) 888-8508
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
163WP0808X
Psychiatric/Mental Health Registered Nurse
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
2084P0800X
Psychiatry Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/06/2022
Last updated
09/04/2026
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