Provider Demographics
NPI:1649592106
Name:THE WELLNESS CENTER OF CENTRAL VIRGINIA, INC.
Entity Type:Organization
Organization Name:THE WELLNESS CENTER OF CENTRAL VIRGINIA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:PARSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:804-310-2444
Mailing Address - Street 1:PO BOX 74100
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23236-0002
Mailing Address - Country:US
Mailing Address - Phone:804-232-8080
Mailing Address - Fax:804-232-8088
Practice Address - Street 1:180 BELT BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224-1204
Practice Address - Country:US
Practice Address - Phone:804-232-8080
Practice Address - Fax:804-232-8088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23234455551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty