Provider Demographics
NPI:1073357505
Name:FAVORED SERVICES, LLC
Entity type:Organization
Organization Name:FAVORED SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:OLAMIDE
Authorized Official - Middle Name:TOKUNBO
Authorized Official - Last Name:KEHINDE
Authorized Official - Suffix:
Authorized Official - Credentials:QMHP
Authorized Official - Phone:434-444-9902
Mailing Address - Street 1:107 CRESTLINE DR
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-1470
Mailing Address - Country:US
Mailing Address - Phone:434-851-8657
Mailing Address - Fax:
Practice Address - Street 1:2250 MURRELL RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-2141
Practice Address - Country:US
Practice Address - Phone:434-444-9902
Practice Address - Fax:434-849-7665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health