Provider Demographics
NPI:1457976631
Name:DUNAMIS GARDEN COUNSELING SERVICES
Entity Type:Organization
Organization Name:DUNAMIS GARDEN COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ELVIS
Authorized Official - Middle Name:F
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MA, LMHP-R, CSAC
Authorized Official - Phone:804-638-4009
Mailing Address - Street 1:1576 OAKLAND CHASE PKWY
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23231-5736
Mailing Address - Country:US
Mailing Address - Phone:804-638-4009
Mailing Address - Fax:
Practice Address - Street 1:1576 OAKLAND CHASE PKWY
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23231-5736
Practice Address - Country:US
Practice Address - Phone:804-638-4009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility