Organization
FULL FOCUS TRAINING CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLEY TUCKER MS (OWNER/PROGRAM DIRECTOR)
(804) 895-2106
Entity
Organization
Contact information
Practice address
1863 FORT MAHONE ST, PETERSBURG, VA 23805-2761
(804) 834-1100
(804) 834-2200
Mailing address
P.O. BOX 213, WAVERLY, VA 23890-0213
(804) 834-1100
(804) 834-2200
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
VA
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
VA
261QR0400X
Rehabilitation Clinic/Center
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2960
—
VA
05
—
2960-02-011
—
VA
Enumeration date
05/17/2018
Last updated
09/11/2025
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