Provider Demographics
NPI:1437041993
Name:BLUE HOUSE RVA
Entity type:Organization
Organization Name:BLUE HOUSE RVA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NATALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRANTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-829-9688
Mailing Address - Street 1:2406 CASCADE MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-4292
Mailing Address - Country:US
Mailing Address - Phone:980-829-9688
Mailing Address - Fax:
Practice Address - Street 1:7800 MILLCREEK DR
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-6742
Practice Address - Country:US
Practice Address - Phone:980-829-9688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)