Provider Demographics
NPI:1932241130
Name:COMMUNITY EMPOWERMENT SERVICES
Entity Type:Organization
Organization Name:COMMUNITY EMPOWERMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAMON
Authorized Official - Middle Name:L
Authorized Official - Last Name:PRATT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:804-614-6086
Mailing Address - Street 1:3404 HOLLOW RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-8560
Mailing Address - Country:US
Mailing Address - Phone:804-614-6086
Mailing Address - Fax:
Practice Address - Street 1:5803 NINE MILE RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-3429
Practice Address - Country:US
Practice Address - Phone:804-614-6086
Practice Address - Fax:757-299-9894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904006485251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health