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Organization

INFLUENTIAL FAMILY SERVICE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DERRICK CHAVIS (COO)
(804) 355-1853
Entity
Organization

Contact information

Practice address
3122 W. MARSHALL ST, 10, RICHMOND, VA 23230-4726
(804) 355-1853
Mailing address
3122 W. MARSHALL ST, 10, RICHMOND, VA 23230
(804) 355-1853

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
1346-05-001
VA
251S00000X
Community/Behavioral Health Agency
Primary
1346-05-001
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1346
VA
Enumeration date
11/24/2009
Last updated
11/24/2009
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