Organization
YOUTH DIVERSITY COALITION, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH FISHER (C.A.O)
(804) 228-3729
Entity
Organization
Contact information
Practice address
2916 VALLEY SIDE TER, RICHMOND, VA 23223-1163
(804) 228-3729
(804) 228-1843
Mailing address
8025 HILLCREEK DR, MIDLOTHIAN, VA 23112-6847
(804) 833-6053
(804) 639-6933
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
S8-04-20
VA
Other
Enumeration date
03/23/2007
Last updated
08/22/2020
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