Organization
CHANGING FACES YOUTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAYMOND DORSEY (DIRECTOR)
(804) 479-1184
Entity
Organization
Contact information
Practice address
1413 IDLEWOOD AVE, RICHMOND, VA 23220-6003
(804) 479-1184
Mailing address
1413 IDLEWOOD AVE, RICHMOND, VA 23220-6003
(804) 479-1184
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1403
VA
Other
Enumeration date
11/03/2009
Last updated
11/03/2009
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