Provider Demographics
NPI:1770501629
Name:COMMUNITY FUTURES FOUNDATION
Entity Type:Organization
Organization Name:COMMUNITY FUTURES FOUNDATION
Other - Org Name:COMMUNITY BRAIN INJURY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:804-386-0925
Mailing Address - Street 1:9211 ARBORETUM PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-5404
Mailing Address - Country:US
Mailing Address - Phone:804-386-0925
Mailing Address - Fax:804-441-9087
Practice Address - Street 1:9211 ARBORETUM PKWY STE 100
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-5404
Practice Address - Country:US
Practice Address - Phone:804-386-0925
Practice Address - Fax:804-441-9087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2084P0301X, 251B00000X
VA010136199251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0301XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBrain Injury MedicineGroup - Single Specialty
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Single Specialty