Organization
SUPPORTIVE INTERVENTION SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEKEISHA SHENNILLE HITE LPC (CLINICAL DIRECTOR)
(804) 330-0310
Entity
Organization
Contact information
Practice address
6946 FOREST HILL AVE, RICHMOND, VA 23225-1606
(804) 330-0310
Mailing address
6946 FOREST HILL AVE, RICHMOND, VA 23225-1606
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1949
VA
Other
Enumeration date
06/06/2013
Last updated
06/06/2013
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