Organization
WELLNESS GROUP YOUTH & FAMILY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN THOMAS REDD III (CEO)
(804) 359-0613
Entity
Organization
Contact information
Practice address
1510 WILLOW LAWN DR, SUITE 10, RICHMOND, VA 23230-3429
(804) 359-0613
(804) 359-0614
Mailing address
1510 WILLOW LAWN DR, SUITE 10, RICHMOND, VA 23230-3429
(804) 359-0613
(804) 359-0614
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
492-03-003
VA
251C00000X
Developmentally Disabled Services Day Training Agency
492-05-001
VA
251E00000X
Home Health Agency
492-03-003
VA
251E00000X
Home Health Agency
Primary
492-05-001
VA
251S00000X
Community/Behavioral Health Agency
492-03-003
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
492-03-003
DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES
VA
01
—
492-05-001
DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES
VA
Enumeration date
09/28/2009
Last updated
01/11/2011
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