Organization
ABUNDANT LIFE CENTER II, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RODNEY MARK WILLIAMS (EXECUTIVE DIRECTOR)
(804) 651-7972
Entity
Organization
Contact information
Practice address
9831 KEVKEN DR, RICHMOND, VA 23237-4058
(804) 748-3368
(804) 748-3662
Mailing address
1313 PLEASANT CREEK CT, COLONIAL HEIGHTS, VA 23834-6841
(804) 651-7972
(804) 530-0195
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
895-14-00
VA
Other
Enumeration date
11/15/2006
Last updated
08/22/2020
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