NPI 1114245180

Edgewood Group Family Services

Organisation Case Management Agency Richmond, VA

Practice location

Address: 4906 Fitzhugh Ave Suite 104, Richmond, VA 23230-3526
Phone: (804) 648-0671
Fax: (804) 648-0672

Authorised official

Name: William Travis Crocker
Title: Ceo
Phone: (804) 648-0671

Registered specialties

Case Management Agency Primary

Agencies Taxonomy 251B00000X Licence 709 (VA)

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Registry record

NPI: 1114245180
Entity type: Organization
NPI issued: 14 May 2010
Record last updated: 14 May 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.