Provider Demographics
NPI:1275604589
Name:KIDS IN FOCUS OF VA
Entity Type:Organization
Organization Name:KIDS IN FOCUS OF VA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BEA
Authorized Official - Middle Name:
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-714-1812
Mailing Address - Street 1:PO BOX 34686
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23234-0686
Mailing Address - Country:US
Mailing Address - Phone:804-714-1812
Mailing Address - Fax:804-714-1824
Practice Address - Street 1:3801 LAKE HILLS RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23234-3664
Practice Address - Country:US
Practice Address - Phone:804-714-1022
Practice Address - Fax:804-714-1824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA538-14-001320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness