Provider Demographics
NPI:1922323955
Name:YOUTH COUNSELING SERVICES OF VIRGINA
Entity Type:Organization
Organization Name:YOUTH COUNSELING SERVICES OF VIRGINA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:GUNN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:804-405-8888
Mailing Address - Street 1:4301 CASTLE DR APT F
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23231-4128
Mailing Address - Country:US
Mailing Address - Phone:804-405-8888
Mailing Address - Fax:
Practice Address - Street 1:4301 CASTLE DR APT F
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23231-4128
Practice Address - Country:US
Practice Address - Phone:804-405-8888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-01
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care