Provider Demographics
NPI:1477254076
Name:NEW ALLIANCE FAMILY SERVICES, LLC
Entity Type:Organization
Organization Name:NEW ALLIANCE FAMILY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CASSONDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACKSTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:MED, QMHP A/C
Authorized Official - Phone:804-835-8970
Mailing Address - Street 1:16812 WARREN CREST CT
Mailing Address - Street 2:
Mailing Address - City:MOSELEY
Mailing Address - State:VA
Mailing Address - Zip Code:23120-2315
Mailing Address - Country:US
Mailing Address - Phone:804-835-8970
Mailing Address - Fax:
Practice Address - Street 1:16812 WARREN CREST CT
Practice Address - Street 2:
Practice Address - City:MOSELEY
Practice Address - State:VA
Practice Address - Zip Code:23120-2315
Practice Address - Country:US
Practice Address - Phone:804-835-8970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-13
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty