Organization
THERAPEUTIC YOUTH COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MYISHA RUSH (CEO)
(703) 209-0809
Entity
Organization
Contact information
Practice address
128 COLTER DR, RICHMOND, VA 23223-1840
(703) 209-0809
Mailing address
128 COLTER DR, RICHMOND, VA 23223-1840
(703) 209-0809
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
2043
VA
Other
Enumeration date
05/28/2014
Last updated
05/28/2014
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