Organization
JUN-LIZZ LLC
Active
Other names
JUN-LIZZ Serenity care
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL LESTER-LEWIS BS QMHP RPRS CSAC-A (OWNER)
(804) 767-9723
Entity
Organization
Contact information
Practice address
4325 MYLAN RD, RICHMOND, VA 23223-2273
(804) 767-9723
Mailing address
4325 MYLAN RD, RICHMOND, VA 23223-2273
(804) 767-9723
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0711000285
VA
101YM0800X
Mental Health Counselor
0732000133
VA
171M00000X
Case Manager/Care Coordinator
Primary
0732000133
VA
175T00000X
Peer Specialist
0735000015
VA
251B00000X
Case Management Agency
0732000133
VA
251E00000X
Home Health Agency
0732000133
VA
Other
Enumeration date
08/28/2018
Last updated
08/28/2018
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