Provider Demographics
NPI:1699962837
Name:ADVANCED SERVICES FOR KIDS, LLC
Entity type:Organization
Organization Name:ADVANCED SERVICES FOR KIDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:K
Authorized Official - Last Name:MCCLURE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-290-9039
Mailing Address - Street 1:1809 LESUER RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-4220
Mailing Address - Country:US
Mailing Address - Phone:804-332-5966
Mailing Address - Fax:804-332-5347
Practice Address - Street 1:1809 LESUER RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-4220
Practice Address - Country:US
Practice Address - Phone:804-332-5966
Practice Address - Fax:804-332-5347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children