Provider Demographics
NPI:1609252618
Name:POSITIVE OUTLOOK LLC
Entity Type:Organization
Organization Name:POSITIVE OUTLOOK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:LAMONT
Authorized Official - Last Name:GIGGETTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-398-1974
Mailing Address - Street 1:8 E CLAY ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23219-1330
Mailing Address - Country:US
Mailing Address - Phone:703-624-3146
Mailing Address - Fax:
Practice Address - Street 1:4877 FINLAY ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23231-2746
Practice Address - Country:US
Practice Address - Phone:804-562-5994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904009074251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health