Provider Demographics
NPI:1013175629
Name:FAMILY RESOLUTION SERVICES
Entity type:Organization
Organization Name:FAMILY RESOLUTION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BEATRICE
Authorized Official - Middle Name:INEZ
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-304-5134
Mailing Address - Street 1:2825 S CRATER RD
Mailing Address - Street 2:#4
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23805-2473
Mailing Address - Country:US
Mailing Address - Phone:804-861-3540
Mailing Address - Fax:804-861-3541
Practice Address - Street 1:2825 S CRATER RD
Practice Address - Street 2:#4
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23805-2473
Practice Address - Country:US
Practice Address - Phone:804-861-3540
Practice Address - Fax:804-861-3541
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AGAPE UNLIMITED II
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-30
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA32205001251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health