The Fountain 4 Youth Therapeutic Services

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

THE FOUNTAIN 4 YOUTH THERAPEUTIC SERVICES

Practice address

3108 N Parham Rd
Henrico, VA 23294-4421

Phone

(804) 508-0904

NPI assigned

Oct 12, 2022

Organization subpart

No

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

Authorized official

Name

Edward C HillNPI 1063159390

Title

Counselor

Phone

(804) 508-0904

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edward Curruth Hill

  • Addiction (Substance Use Disorder) Counselor
  • Henrico, VA
  • NPI 1063159390
  NPD Authorized official

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665532800000",
    "number": "1851016885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3108 N PARHAM RD",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232944421",
            "telephone_number": "804-508-0904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3108 N PARHAM RD",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232944421",
            "telephone_number": "804-508-0904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FOUNTAIN 4 YOUTH THERAPEUTIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-12",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "804-508-0904"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Henrico, VA
• Providers in Henrico, VA by specialty
• Substance Abuse Rehabilitation Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; 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.