New Legacy Youth Services, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

1418 Issued in VA

Legal business name

NEW LEGACY YOUTH SERVICES, LLC

Practice address

904 North 1St Street
Richmond, VA 23219

Phone

(804) 479-5908

NPI assigned

Jun 15, 2012

Last updated

Jun 15, 2012By 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

Kendrick Kelly, QMHP

Title

Executive Director

Phone

(804) 479-5908

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1339718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339718400000",
    "number": "1932461852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 NORTH 1ST ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232191000",
            "telephone_number": "804-479-5908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 NORTH 1ST STREET",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23219",
            "telephone_number": "804-479-5908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW LEGACY YOUTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-15",
        "last_updated": "2012-06-15",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "KENDRICK",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "804-479-5908",
        "authorized_official_credential": "QMHP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "VA",
            "license": "1418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Richmond, VA
• Providers in Richmond, VA by specialty
• Community/Behavioral Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; 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.