Organization
A VILLAGE YOUTH & FAMILY SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHIDHRA SMITH POOLE LCSW, DSW (OWNER)
(804) 225-0749
Entity
Organization
Contact information
Practice address
625 PINEY FOREST RD STE 302D, DANVILLE, VA 24540-2869
(434) 264-7760
(804) 225-0753
Mailing address
2025 E MAIN ST STE 104, RICHMOND, VA 23223-7072
(042) 250-7498
(804) 225-0753
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093138455
—
VA
Enumeration date
05/24/2018
Last updated
05/24/2018
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