Provider Demographics
NPI:1053872135
Name:FOREVER ENDEAVOR LLC
Entity type:Organization
Organization Name:FOREVER ENDEAVOR LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:L
Authorized Official - Last Name:BYRD
Authorized Official - Suffix:SR
Authorized Official - Credentials:LMHP-R
Authorized Official - Phone:143-460-7729
Mailing Address - Street 1:1 MILL ST STE 100
Mailing Address - Street 2:
Mailing Address - City:FARMVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23901-3401
Mailing Address - Country:US
Mailing Address - Phone:434-315-0000
Mailing Address - Fax:434-315-8759
Practice Address - Street 1:1 MILL ST STE 100
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901-3401
Practice Address - Country:US
Practice Address - Phone:434-315-0000
Practice Address - Fax:434-315-8759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-29
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health