Provider Demographics
| NPI: | 1033804596 |
|---|---|
| Name: | THE CONFESS PROJECT OF THE SOUTHEAST |
| Entity Type: | Organization |
| Organization Name: | THE CONFESS PROJECT OF THE SOUTHEAST |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CEO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | KAROLYN |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | TAYLOR |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 501-413-8899 |
| Mailing Address - Street 1: | 405 E LABURNUM AVE STE 3 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | RICHMOND |
| Mailing Address - State: | VA |
| Mailing Address - Zip Code: | 23222-2120 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 501-413-8899 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 405 E LABURNUM AVE STE 3 |
| Practice Address - Street 2: | |
| Practice Address - City: | RICHMOND |
| Practice Address - State: | VA |
| Practice Address - Zip Code: | 23222-2120 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 501-413-8899 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2023-04-10 |
| Last Update Date: | 2023-04-10 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 251S00000X | Agencies | Community/Behavioral Health | |
| No | 251B00000X | Agencies | Case Management | |
| No | 251K00000X | Agencies | Public Health or Welfare | |
| No | 251V00000X | Agencies | Voluntary or Charitable | |
| No | 252Y00000X | Agencies | Early Intervention Provider Agency | |
| No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | |
| No | 261QC1500X | Ambulatory Health Care Facilities | Clinic/Center | Community Health |
| No | 261QH0100X | Ambulatory Health Care Facilities | Clinic/Center | Health Service |
| No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
| No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health |
| No | 261QP0904X | Ambulatory Health Care Facilities | Clinic/Center | Public Health, Federal |
| No | 261QR0401X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| No | 261QR1300X | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
| No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness |
