Provider Demographics
NPI:1679338875
Name:NEXT LEVEL SUPPORTIVE SERVICES LLC
Entity type:Organization
Organization Name:NEXT LEVEL SUPPORTIVE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:RACHELLE
Authorized Official - Middle Name:LAMARIS
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:804-955-9983
Mailing Address - Street 1:3808 SEASONS LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-1604
Mailing Address - Country:US
Mailing Address - Phone:804-955-9983
Mailing Address - Fax:
Practice Address - Street 1:3808 SEASONS LN
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-1604
Practice Address - Country:US
Practice Address - Phone:804-955-9983
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)