Organization
PROACTIVE CHANGE
Active
Organization
PROACTIVE CHANGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON HOLLEY (CEO)
(804) 909-9928
Entity
Organization
Contact information
Practice address
605 TWINRIDGE LN, NORTH CHESTERFIELD, VA 23235-5268
(804) 909-7395
Mailing address
605 TWINRIDGE LN, NORTH CHESTERFIELD, VA 23235-5268
(804) 909-7395
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
05/08/2026
Last updated
07/07/2026
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