Organization
FROM THE GROUND UP YOUTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANINE KEYUNI JACKSON (DIRECTOR)
(804) 503-0466
Entity
Organization
Contact information
Practice address
9510 STOCKBRIDGE DR, RICHMOND, VA 23228-1223
(804) 503-0466
(804) 440-0727
Mailing address
9510 STOCKBRIDGE DR, RICHMOND, VA 23228-1223
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1168
VA
Other
Enumeration date
03/04/2008
Last updated
03/04/2008
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