Organization
IVY ROOTS LLC
Active
Other names
Ivy Roots LLC
Organization subpart
No
Provider details
NPI number
Authorized official
SHANELL JANESE WILLIAMS B.S, QMHP-A (CEO/ OWNER)
(804) 896-6607
Entity
Organization
Contact information
Practice address
3422 R ST, RICHMOND, VA 23223-6877
(804) 896-6607
(804) 896-6607
Mailing address
3422 R ST, RICHMOND, VA 23223-6877
(804) 896-6607
(804) 896-6607
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
03/03/2025
Last updated
03/03/2025
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