Provider Demographics
NPI:1104119429
Name:JOURNEYS SENIOR SOLUTIONS LLC
Entity type:Organization
Organization Name:JOURNEYS SENIOR SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:540-223-1144
Mailing Address - Street 1:277 FOXBROOK LN
Mailing Address - Street 2:PO BOX 1733
Mailing Address - City:LOUISA
Mailing Address - State:VA
Mailing Address - Zip Code:23093-4042
Mailing Address - Country:US
Mailing Address - Phone:540-223-1144
Mailing Address - Fax:540-967-0731
Practice Address - Street 1:277 FOXBROOK LN
Practice Address - Street 2:
Practice Address - City:LOUISA
Practice Address - State:VA
Practice Address - Zip Code:23093-4042
Practice Address - Country:US
Practice Address - Phone:540-223-1144
Practice Address - Fax:540-967-0731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-19
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904007401251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1508161191OtherNPPES