Provider Demographics
NPI:1952622201
Name:NDUTIME YOUTH & FAMILY SERVICES, INC.
Entity Type:Organization
Organization Name:NDUTIME YOUTH & FAMILY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TESHANA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:804-303-8383
Mailing Address - Street 1:5801 CHAMBERLAYNE RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23227-1912
Mailing Address - Country:US
Mailing Address - Phone:804-303-8393
Mailing Address - Fax:804-303-8398
Practice Address - Street 1:5801 CHAMBERLAYNE RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23227-1912
Practice Address - Country:US
Practice Address - Phone:804-303-8393
Practice Address - Fax:804-303-8398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA758251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health