Provider Demographics
NPI:1306151477
Name:CITY OF RICHMOND
Entity type:Organization
Organization Name:CITY OF RICHMOND
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTRO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:J
Authorized Official - Last Name:KEHOE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:804-646-3902
Mailing Address - Street 1:3600 W BROAD ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-4915
Mailing Address - Country:US
Mailing Address - Phone:804-646-5987
Mailing Address - Fax:804-646-3269
Practice Address - Street 1:3600 W BROAD ST
Practice Address - Street 2:SUITE 400
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-4915
Practice Address - Country:US
Practice Address - Phone:804-646-5987
Practice Address - Fax:804-646-3269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-13
Last Update Date:2010-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA93805001251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health