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Organization

ANOVA LEVEL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LATAUSHA BOONE LPC (CEO)
(804) 439-7578
Entity
Organization

Contact information

Practice address
2025 E MAIN ST STE 205, RICHMOND, VA 23223-7073
(804) 439-7578
(804) 438-2533
Mailing address
PO BOX 38936, HENRICO, VA 23231-1311
(804) 439-7578
(804) 438-2533

Taxonomy

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

Other

Enumeration date
10/18/2025
Last updated
10/18/2025
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