Organization
D.Y.V.I.N.E YOUTH SERVICES LLC
Active
Organization
D.Y.V.I.N.E YOUTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS NICOLE CAPRICE CULBRETH MHS (CEO)
(804) 267-0846
Entity
Organization
Contact information
Practice address
6956 FOREST HILL AVE STE B, RICHMOND, VA 23225-1657
(804) 562-4206
Mailing address
6956 FOREST HILL AVE STE B, RICHMOND, VA 23225-1657
(804) 562-4206
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
127905001
VA
Other
Enumeration date
01/02/2010
Last updated
01/02/2010
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