Organization
BROKEN CHAIN FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC CHRISTOPHER HARRIS (CEO/EXECUTIVE DIRECTOR)
(804) 405-3206
Entity
Organization
Contact information
Practice address
4824 KELLYWOOD DR, GLEN ALLEN, VA 23060-3643
(804) 405-3206
(804) 658-3105
Mailing address
4824 KELLYWOOD DR, GLEN ALLEN, VA 23060-3643
(804) 405-3206
(804) 658-3105
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
0000000000
VA
Other
Enumeration date
05/13/2009
Last updated
05/13/2009
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