PROVIDENCE BEHAVIORAL HEALTH LLC

WOODBRIDGE, VA
NPI1265131148
Entity TypeOrganization
Authorized ContactMARIAH EZE
Owner
703-950-9202
Organization Subpart ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
Enumeration Date2023-02-28
Last Update Date2023-10-26
Business Address
PROVIDENCE BEHAVIORAL HEALTH LLC
15262 FLINTLOCK TER
WOODBRIDGE, VA 22191
Phone number: 703-950-9202
Mailing Address
PROVIDENCE BEHAVIORAL HEALTH LLC
4222 FORTUNA CENTER PLZ STE 607
DUMFRIES, VA 22025-1515
Phone number: 703-650-9202
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