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Organization

YOUTH AND FAMILY DYNAMICS IN-HOME SERVICES,LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALLEN FITZGERALD JACKSON JR. (CHIEF EXECUTIVE OFFICER)
(804) 501-9440
Entity
Organization

Contact information

Practice address
5741 SOUTH LABURNUM AVENUE, HENRICO, VA 23231-4726
(804) 501-9440
Mailing address
1733 FIRST COLONIAL COURT, HENRICO, VA 23231-4726
(804) 501-9440

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
S242537-1
VA

Other

Enumeration date
09/16/2008
Last updated
03/28/2012
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