Organization
YOUTH AND FAMILY DYNAMICS IN-HOME SERVICES,LLC
Active
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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