Provider Demographics
NPI:1003383126
Name:NOT JUST PLAY, LLC
Entity Type:Organization
Organization Name:NOT JUST PLAY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HORNSTRA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:804-305-4621
Mailing Address - Street 1:9099 MOSSYBROOK RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-6547
Mailing Address - Country:US
Mailing Address - Phone:804-305-4621
Mailing Address - Fax:844-658-9554
Practice Address - Street 1:6501 MECHANICSVILLE TPKE STE G3
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-3698
Practice Address - Country:US
Practice Address - Phone:804-305-4621
Practice Address - Fax:844-658-9554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-26
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)