Organization
NEW LEGACY YOUTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENDRICK KELLY QMHP (EXECUTIVE DIRECTOR)
(804) 479-5908
Entity
Organization
Contact information
Practice address
904 NORTH 1ST STREET, RICHMOND, VA 23219
(804) 479-5908
Mailing address
904 NORTH 1ST ST, RICHMOND, VA 23219-1000
(804) 479-5908
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1418
VA
Other
Enumeration date
06/15/2012
Last updated
06/15/2012
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