Advanced Behavioral Health Services, Llc | |
1241 Mall Dr North Chesterfield VA 23235-4879 | |
(804) 539-2557 | |
Not Available |
Full Name | Advanced Behavioral Health Services, Llc |
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Speciality | Community/Behavioral Health |
Location | 1241 Mall Dr, North Chesterfield, Virginia |
Authorized Official Name and Position | Alan Thomas Von Kleiss (CEO- CLINICAL PSYCHOLOGIST) |
Authorized Official Contact | 8045392557 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Advanced Behavioral Health Services, Llc 7514 Van Hoy Dr North Chesterfield VA 23235-6454 Ph: (804) 539-2557 | Advanced Behavioral Health Services, Llc 1241 Mall Dr North Chesterfield VA 23235-4879 Ph: (804) 539-2557 |
NPI Number | 1780923292 |
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Provider Enumeration Date | 02/04/2013 |
Last Update Date | 02/04/2013 |
Medicare PECOS PAC ID | 4082858501 |
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Medicare Enrollment ID | O20130923000419 |
Identifier | Type | State | Issuer |
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1780923292 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | 0810004544 (Virginia) | Primary |
Provider Name | Alan Thomas Maximus Von Kleiss |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1790058899 PECOS PAC ID: 5991949414 Enrollment ID: I20130923000437 |
Provider Name | Rae Anne P Dougan |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1326415837 PECOS PAC ID: 3577854090 Enrollment ID: I20160614000539 |
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