Provider Demographics
NPI:1679737886
Name:VIRGINIA SUPPORTIVE HOUSING
Entity Type:Organization
Organization Name:VIRGINIA SUPPORTIVE HOUSING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:TOUSIGNANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-836-1051
Mailing Address - Street 1:PO BOX 8585
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-0585
Mailing Address - Country:US
Mailing Address - Phone:804-836-1051
Mailing Address - Fax:804-788-6827
Practice Address - Street 1:1010 N THOMPSON ST
Practice Address - Street 2:SUITE 200
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-4911
Practice Address - Country:US
Practice Address - Phone:804-788-6825
Practice Address - Fax:804-788-6827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1003-03-001251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health