Basic Information
| Provider Information | |||||||||
| NPI: | 1942237243 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | FAMILY FOCUS, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2727 ENTERPRISE PKWY STE 202 | ||||||||
| Address2: | |||||||||
| City: | HENRICO | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232946341 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8042612090 | ||||||||
| FaxNumber: | 8042613962 | ||||||||
| Practice Location | |||||||||
| Address1: | 2103 E PARHAM RD | ||||||||
| Address2: | 100 | ||||||||
| City: | RICHMOND | ||||||||
| State: | VA | ||||||||
| PostalCode: | 232282235 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8042612090 | ||||||||
| FaxNumber: | 8042613962 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2006 | ||||||||
| LastUpdateDate: | 12/16/2020 | ||||||||
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| AuthorizedOfficialLastName: | HARRIS | ||||||||
| AuthorizedOfficialFirstName: | PATRICIA | ||||||||
| AuthorizedOfficialMiddleName: | I | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8042612090 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | NCC,LPC,LMFT,CSOTP | ||||||||
| NPICertificationDate: | 12/16/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251B00000X | Y | Agencies | Case Management |
ID Information
| ID | Type | State | Issuer | Description | 004942418 | 05 | VA | MEDICAID | 010050499 | 05 | VA | MEDICAID |