NPIMap

Organization Active NPI

Faithful Friends Family Services, LLC

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Petersburg, VA
National Provider Identifier
1659970309
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
FAITHFUL FRIENDS FAMILY SERVICES, LLC
Doing business as
Faithful Friends Family Services, LLC
Practice address
1040 7TH St
Petersburg, VA 23803-5259
Phone
(804) 661-2096
Fax
(804) 823-8077
NPI assigned
Oct 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Raymond Bradley III, QDDP
Title
Ceo
Phone
(804) 661-2096

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Primary

Addresses

Primary practice location

1040 7TH St
Petersburg, VA 23803-5259

Mailing address

20814 Truth Dr
South Chesterfield, VA 23803-1830
Phone (804) 661-2096

Other names 1

  • Faithful Friends Family Services, LLC Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Petersburg Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603411200000",
    "number": "1659970309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20814 TRUTH DR",
            "city": "SOUTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "238031830",
            "telephone_number": "804-661-2096",
            "fax_number": "804-823-8077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 7TH ST",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238035259",
            "telephone_number": "804-661-2096",
            "fax_number": "804-823-8077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITHFUL FRIENDS FAMILY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-23",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "804-661-2096",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "QDDP"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Petersburg",
            "affiliation": "N",
            "endpointDescription": "Service Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1040 7th St",
            "city": "Petersburg",
            "state": "VA",
            "country_code": "US",
            "postal_code": "238035259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Faithful Friends Family Services, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Petersburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.