Organization
ULTIMATE OUTCOMES THERAPEUTIC SERVICES
Active
Organization
ULTIMATE OUTCOMES THERAPEUTIC SERVICES
Active
Other names
Ultimate Outcomes Therapuetic Services
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE BAZEMORE (ADMINISTRATOR)
(804) 213-0140
Entity
Organization
Contact information
Practice address
4901 FITZHUGH AVE STE 200, RICHMOND, VA 23230-3531
(804) 213-0140
(804) 213-0140
Mailing address
PO BOX 6386, RICHMOND, VA 23230-0386
(804) 213-0140
(804) 213-0143
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
46403001
VA
251S00000X
Community/Behavioral Health Agency
46405001
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801124607
—
VA
Enumeration date
12/07/2009
Last updated
05/02/2019
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