Provider Demographics
NPI:1295065357
Name:M.I.N.K.S. YOUTH & FAMILY SERVICES
Entity type:Organization
Organization Name:M.I.N.K.S. YOUTH & FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:HANKS
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:804-908-6465
Mailing Address - Street 1:4801 HERMITAGE RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-3332
Mailing Address - Country:US
Mailing Address - Phone:804-908-6465
Mailing Address - Fax:
Practice Address - Street 1:4801 HERMITAGE RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-3332
Practice Address - Country:US
Practice Address - Phone:804-908-6465
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-12
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 251B00000X, 261QC1500X, 261QM0801X, 261QM0855X, 261QM1000X, 261QR0400X, 261QR0401X, 261QM0850X, 261QR0401X
VA251C00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM1000XAmbulatory Health Care FacilitiesClinic/CenterMigrant Health
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health