Provider Demographics
NPI:1083312573
Name:THE COLLECTIVE MENTAL HEALTH PERSPECTIVE, LLC
Entity Type:Organization
Organization Name:THE COLLECTIVE MENTAL HEALTH PERSPECTIVE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-501-9440
Mailing Address - Street 1:1733 FIRST COLONIAL CT
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23231-6892
Mailing Address - Country:US
Mailing Address - Phone:804-501-9440
Mailing Address - Fax:
Practice Address - Street 1:11500 NORTHWEST FWY STE 465A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-6538
Practice Address - Country:US
Practice Address - Phone:804-501-9440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-23
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)