Provider Demographics
NPI:1639956667
Name:CENTRAL VIRGINIA BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:CENTRAL VIRGINIA BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAHEIM
Authorized Official - Middle Name:
Authorized Official - Last Name:TIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-536-0105
Mailing Address - Street 1:1808 DUBLIN ST
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:VA
Mailing Address - Zip Code:23860-6209
Mailing Address - Country:US
Mailing Address - Phone:804-536-0105
Mailing Address - Fax:
Practice Address - Street 1:43 RIVES RD STE A
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23805-9427
Practice Address - Country:US
Practice Address - Phone:804-536-0105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health