Organization
A VILLAGE YOUTH & FAMILY SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHIDHRA S POOLE LCSW, DSW (CEO)
(804) 551-7363
Entity
Organization
Contact information
Practice address
2025 E MAIN ST STE 104, RICHMOND, VA 23223-7072
(804) 225-0749
(804) 225-0753
Mailing address
2025 E MAIN ST STE 104, RICHMOND, VA 23223-7072
(804) 225-0749
(804) 225-0753
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
516
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093138455
—
VA
Enumeration date
11/18/2016
Last updated
11/18/2016
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