Organization
IMPACT ON YOUTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LASHANDA JENKINS (CEO)
(804) 437-5697
Entity
Organization
Contact information
Practice address
201 S LAKE AVE, RICHMOND, VA 23223-6211
(804) 437-5697
Mailing address
201 S LAKE AVE, RICHMOND, VA 23223-6211
(804) 437-5697
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/15/2019
Last updated
01/15/2019
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