Provider Demographics
NPI:1467695338
Name:T.O.D.A.Y.S. YOUTH SERVICES, LLC
Entity Type:Organization
Organization Name:T.O.D.A.Y.S. YOUTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KOBI
Authorized Official - Middle Name:JERON
Authorized Official - Last Name:MULLINS
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:804-355-5170
Mailing Address - Street 1:3122 W MARSHALL ST
Mailing Address - Street 2:SUITE 216
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-4726
Mailing Address - Country:US
Mailing Address - Phone:804-355-5170
Mailing Address - Fax:804-355-5172
Practice Address - Street 1:3122 W MARSHALL ST
Practice Address - Street 2:SUITE 216
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-4726
Practice Address - Country:US
Practice Address - Phone:804-355-5170
Practice Address - Fax:804-355-5172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-08
Last Update Date:2009-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA875-05251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health