Imagination LLC

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

3189-14-008 Issued in VA

Legal business name

IMAGINATION LLC

Practice address

318 N Wilkinson Rd
Richmond, VA 23227-1631

Phone

(804) 716-0593

Fax

(804) 330-6698

NPI assigned

Mar 31, 2018

Organization subpart

No

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

Authorized official

Name

Ms. Monica Bolton

Title

Chief Administrative Officer

Phone

(804) 402-1356

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1522454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522454400000",
    "number": "1871099721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28586",
            "city": "HENRICO",
            "state": "VA",
            "postal_code": "232288586",
            "telephone_number": "804-716-0593",
            "fax_number": "804-330-6698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 N WILKINSON RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232271631",
            "telephone_number": "804-716-0593",
            "fax_number": "804-330-6698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGINATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-31",
        "last_updated": "2018-03-31",
        "status": "A",
        "authorized_official_last_name": "BOLTON",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "804-402-1356",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "VA",
            "license": "3189-14-008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ismail Hussain Ilayan
• Sara Marie Illig, RD
• Colleen Marie Illsley, NP
• Obioma Ikenna Ilouga, MD
• Rachael Im
• Daisuke Imai, MD
• Kimberly M Imajo, AU.D.
• Imani Healthcare Services Inc.
• Terence Alfred Imbery, D.D.S
• Hal Irwin Imburg, LPC

• Emotionally Disturbed Childrens' Residential Treatment Facility in Richmond, VA
• Providers in Richmond, VA by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2018; 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.