Influential Family Service, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

1346-05-001 Issued in VA

Legal business name

INFLUENTIAL FAMILY SERVICE, INC.

Practice address

3122 W. Marshall St
10
Richmond, VA 23230-4726

Phone

(804) 355-1853

NPI assigned

Nov 24, 2009

Last updated

Nov 24, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Derrick Chavis

Title

Coo

Phone

(804) 355-1853

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1259020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259020800000",
    "number": "1912235235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3122 W. MARSHALL ST",
            "address_2": "10",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23230",
            "telephone_number": "804-355-1853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3122 W. MARSHALL ST",
            "address_2": "10",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232304726",
            "telephone_number": "804-355-1853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFLUENTIAL FAMILY SERVICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-24",
        "last_updated": "2009-11-24",
        "status": "A",
        "authorized_official_last_name": "CHAVIS",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "804-355-1853",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "VA",
            "license": "1346-05-001",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VA",
            "license": "1346-05-001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2009; 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.