Organization
LIFE COACH COMMUNITY SERVICES OF VIRGINIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN ALEXANDER PARSON JR. (CEO)
(804) 230-4760
Entity
Organization
Contact information
Practice address
180 BELT BLVD, RICHMOND, VA 23224-1204
(804) 230-4760
(804) 230-4766
Mailing address
PO BOX 74100, RICHMOND, VA 23236-0002
(804) 230-4760
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
788
VA
251S00000X
Community/Behavioral Health Agency
788-17-001
VA
Other
Enumeration date
01/24/2010
Last updated
02/11/2010
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