NPIMap

Organization Active NPI

Changing Faces Youth Services, LLC

  • Community/Behavioral Health Agency
  • Hampton, VA
National Provider Identifier
1790080760
Registry record updated Jan 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
1403-05-001 Issued in VA
Legal business name
CHANGING FACES YOUTH SERVICES, LLC
Practice address
4410 Claiborne SQ E
Suite 200
Hampton, VA 23666-2071
Phone
(804) 353-2397
Fax
(804) 353-2022
NPI assigned
Jan 21, 2011
Last updated
Jan 21, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2011

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

Authorized official

Name
Mr. Raymond Dorsey
Title
Chief Executive Director
Phone
(804) 479-1184

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 1403-05-001 VA Primary

Addresses

Primary practice location

4410 Claiborne SQ E
Suite 200
Hampton, VA 23666-2071

Mailing address

1413 Idlewood Ave
Richmond, VA 23220-6003
Phone (804) 353-2397

National Provider Directory

National Provider Directory
Tax ID family
Changing Faces Youth Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4410 Claiborne Sq E
Ste 200
Hampton, VA 23666
Phone (804) 353-2397

NPI Registry JSON

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

{
    "created_epoch": "1295568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295568000000",
    "number": "1790080760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 IDLEWOOD AVE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232206003",
            "telephone_number": "804-353-2397",
            "fax_number": "804-353-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4410 CLAIBORNE SQ E",
            "address_2": "SUITE 200",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236662071",
            "telephone_number": "804-353-2397",
            "fax_number": "804-353-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGING FACES YOUTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-21",
        "last_updated": "2011-01-21",
        "status": "A",
        "authorized_official_last_name": "DORSEY",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "804-479-1184",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VA",
            "license": "1403-05-001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2011; 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.