Provider Demographics
NPI:1477097327
Name:A WALK THROUGH LIFE MHSS, LLC
Entity Type:Organization
Organization Name:A WALK THROUGH LIFE MHSS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SYREETA
Authorized Official - Middle Name:MARSHEA
Authorized Official - Last Name:REDD
Authorized Official - Suffix:
Authorized Official - Credentials:QMHPP
Authorized Official - Phone:757-998-5624
Mailing Address - Street 1:13327 THORNRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-4839
Mailing Address - Country:US
Mailing Address - Phone:757-998-5624
Mailing Address - Fax:804-716-8399
Practice Address - Street 1:13327 THORNRIDGE LN
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-4839
Practice Address - Country:US
Practice Address - Phone:757-998-5624
Practice Address - Fax:804-716-8399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2560251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health