Organization
CHANGING FACES YOUTH SERVICES, LLC
Active
Organization
CHANGING FACES YOUTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAYMOND DORSEY (CHIEF EXECUTIVE DIRECTOR)
(804) 479-1184
Entity
Organization
Contact information
Practice address
4410 CLAIBORNE SQ E, SUITE 200, HAMPTON, VA 23666-2071
(804) 353-2397
(804) 353-2022
Mailing address
1413 IDLEWOOD AVE, RICHMOND, VA 23220-6003
(804) 353-2397
(804) 353-2022
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1403-05-001
VA
Other
Enumeration date
01/21/2011
Last updated
01/21/2011
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