Provider Demographics
NPI:1043781800
Name:B AND C THERAPEUTIC SERVICES LLC
Entity Type:Organization
Organization Name:B AND C THERAPEUTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWNRELL
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:BLACKWELL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:804-586-5679
Mailing Address - Street 1:2025 E MAIN ST STE 202
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-7073
Mailing Address - Country:US
Mailing Address - Phone:804-586-5679
Mailing Address - Fax:804-214-2270
Practice Address - Street 1:2025 E MAIN ST STE 202
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-7073
Practice Address - Country:US
Practice Address - Phone:804-586-5679
Practice Address - Fax:804-214-2270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health