Provider Demographics
NPI: | 1528780848 |
---|---|
Name: | OPPORTUNITIES FOR A BETTER TOMORROW, LLC |
Entity type: | Organization |
Organization Name: | OPPORTUNITIES FOR A BETTER TOMORROW, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | KEISHA |
Authorized Official - Middle Name: | NICOLE |
Authorized Official - Last Name: | CADDLE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MSW, LCSW-S |
Authorized Official - Phone: | 804-909-3497 |
Mailing Address - Street 1: | 10109 KRAUSE RD STE 201 |
Mailing Address - Street 2: | |
Mailing Address - City: | CHESTERFIELD |
Mailing Address - State: | VA |
Mailing Address - Zip Code: | 23832-6501 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 804-909-3497 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 10109 KRAUSE RD STE 201 |
Practice Address - Street 2: | |
Practice Address - City: | CHESTERFIELD |
Practice Address - State: | VA |
Practice Address - Zip Code: | 23832-6501 |
Practice Address - Country: | US |
Practice Address - Phone: | 804-909-3497 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2022-09-13 |
Last Update Date: | 2022-09-13 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |