# AXIS ALLIANCE NETWORK LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518682038
- **Authorized official:** KYMBERLI DIAMOND LPC (CEO)
- **Authorized official phone:** (804) 687-8558

## Contact information

- **Practice address:** 4800 W HUNDRED RD STE C, CHESTER, VA 23831-1746
- **Practice address phone:** (804) 533-2293
- **Practice address fax:** (804) 597-0219
- **Mailing address:** 5519 BACKWATER TER, NORTH CHESTERFIELD, VA 23234-7732
- **Mailing address phone:** (804) 687-8558

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |

## Other

- **Enumeration date:** 10/06/2022
- **Last updated:** 10/06/2022