Organization
DIAMONDS IN THE ROUGH YOUTH AND FAMILY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STEPHANIE LYNN DIXON (ADMINISTRATOR)
(804) 213-0140
Entity
Organization
Contact information
Practice address
4901 FITZHUGH AVE., STE. 200, RICHMOND, VA 23230-3531
(804) 213-0140
(804) 213-0143
Mailing address
P O BOX 6386, RICHMOND, VA 23230-3531
(804) 213-0140
(804) 213-0143
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
464-05-001
VA
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
464-14-001
VA
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
464-14-001
VA
Other
Enumeration date
01/02/2008
Last updated
05/25/2018
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