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Organization

ANEW LIVING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LATOYA L GREEN QMHP (CEO/PROGRAM DIRECTOR)
(804) 451-9939
Entity
Organization

Contact information

Practice address
21206 CHESTERFIELD AVE STE B, SOUTH CHESTERFIELD, VA 23803-1920
(804) 451-9939
Mailing address
21206 CHESTERFIELD AVE STE B, SOUTH CHESTERFIELD, VA 23803-1920
(804) 451-9939

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2989
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2989
VA
Enumeration date
04/12/2018
Last updated
04/12/2018
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