Provider Demographics
NPI:1386895258
Name:GENERATION X-CEL YOUTH & FAMILY SERVICES
Entity type:Organization
Organization Name:GENERATION X-CEL YOUTH & FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAROME
Authorized Official - Middle Name:ANTOINE
Authorized Official - Last Name:KENNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-257-5539
Mailing Address - Street 1:3122 W MARSHALL ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-4726
Mailing Address - Country:US
Mailing Address - Phone:804-257-5539
Mailing Address - Fax:804-257-5444
Practice Address - Street 1:5024 BRYANBELL LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23234-8004
Practice Address - Country:US
Practice Address - Phone:804-279-8995
Practice Address - Fax:804-279-8996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA349-14-002320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness