Basic Information
| Provider Information | |||||||||
| NPI: | 1619174786 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ONE OF OUR OWN, LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | VISIONS IN ACTION | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7003 MECHANICSVILLE TPKE | ||||||||
| Address2: | SUITE 1111 | ||||||||
| City: | MECHANICSVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 231117100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8046581506 | ||||||||
| FaxNumber: | 8662178718 | ||||||||
| Practice Location | |||||||||
| Address1: | 3921 MONTCLAIR RD | ||||||||
| Address2: | |||||||||
| City: | RICHMOND | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232231146 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8046581506 | ||||||||
| FaxNumber: | 8662178718 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | SMITH | ||||||||
| AuthorizedOfficialFirstName: | JAWANDA | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF ADMINISTRATIVE OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 8046581506 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 322D00000X | SS-358-07 | VA | Y | Residential Treatment Facilities | Residential Treatment Facility, Emotionally Disturbed Children |
No ID Information.