Provider Demographics
NPI:1093138455
Name:A VILLAGE YOUTH & FAMILY SERVICES INC.
Entity Type:Organization
Organization Name:A VILLAGE YOUTH & FAMILY SERVICES INC.
Other - Org Name:VILLAGE BEHAVIORAL HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KHIDHRA
Authorized Official - Middle Name:S
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:804-551-7363
Mailing Address - Street 1:2025 E MAIN ST STE 7
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-7069
Mailing Address - Country:US
Mailing Address - Phone:804-225-0749
Mailing Address - Fax:804-225-0753
Practice Address - Street 1:2025 E MAIN ST
Practice Address - Street 2:SUITE 104
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-7069
Practice Address - Country:US
Practice Address - Phone:804-225-0749
Practice Address - Fax:804-225-0753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-21
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health