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Organization

CHANGING FAZES YOUTH & FAMILY SERVICES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. SHENITA WILLIAMS LCSW (PROGRAM DIRECTOR)
(804) 344-3730
Entity
Organization

Contact information

Practice address
2025 E MAIN ST, SUITE 212, RICHMOND, VA 23223-7069
(804) 344-3730
(804) 344-3731
Mailing address
2025 E MAIN ST, SUITE 212, RICHMOND, VA 23223-7069
(804) 344-3730
(804) 344-3731

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
572
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010003393
VA
Enumeration date
10/27/2006
Last updated
08/10/2009
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