Provider Demographics
NPI:1659818409
Name:COMMONWEALTH CENTER FOR FAMILY SERVICES, INCORPORATED
Entity Type:Organization
Organization Name:COMMONWEALTH CENTER FOR FAMILY SERVICES, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:REMY
Authorized Official - Middle Name:JONES
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-986-7848
Mailing Address - Street 1:7442 WILD SENNA TER
Mailing Address - Street 2:
Mailing Address - City:MOSELEY
Mailing Address - State:VA
Mailing Address - Zip Code:23120-1099
Mailing Address - Country:US
Mailing Address - Phone:804-986-7848
Mailing Address - Fax:
Practice Address - Street 1:7442 WILD SENNA TER
Practice Address - Street 2:
Practice Address - City:MOSELEY
Practice Address - State:VA
Practice Address - Zip Code:23120-1099
Practice Address - Country:US
Practice Address - Phone:804-986-7848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-31
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2595251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health