NPI 1710209150

Spain Residential Program

Organisation Mental Illness Community Based Residential Treatment Facility Henrico, VA

Practice location

Address: 5941 Almond Tree Ter, Henrico, VA 23231-4789
Phone: (804) 523-7702
Fax: (866) 383-5281
Mailing address: 2916 Chamberlayne Ave, Richmond, VA 23222-3506

Authorised official

Name: Andre Smith
Title: Owner
Phone: (804) 523-7702

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X Licence CO-435-10 (VA)

Other Community Based Residential Treatment Facility, Mental Illness providers in Virginia →

Registry record

NPI: 1710209150
Entity type: Organization
NPI issued: 26 Feb 2010
Record last updated: 26 Feb 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.