Provider Demographics
NPI:1508915091
Name:DIVERSITY TRAINING & SUPPORT CENTER
Entity Type:Organization
Organization Name:DIVERSITY TRAINING & SUPPORT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITTINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:804-405-4000
Mailing Address - Street 1:PO BOX 74425
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23236-0008
Mailing Address - Country:US
Mailing Address - Phone:804-405-4000
Mailing Address - Fax:804-743-1845
Practice Address - Street 1:9301 HULL STREET RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23236-1658
Practice Address - Country:US
Practice Address - Phone:804-405-4000
Practice Address - Fax:804-743-1845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA70202006251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA70202006OtherDMHMRSAS PROVIDER #