| Calm Source, Llc | |
|
1045 Main St Ste 6 Danville VA 24541-1800 | |
| (434) 835-2370 | |
| (434) 835-2028 |
| Full Name | Calm Source, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1045 Main St Ste 6, Danville, Virginia |
| Authorized Official Name and Position | Leon Edmund Zimmermann (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 4348352370 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Calm Source, Llc 103 S Main St Danville VA 24541-2921 Ph: (434) 857-2316 | Calm Source, Llc 1045 Main St Ste 6 Danville VA 24541-1800 Ph: (434) 835-2370 |
| NPI Number | 1770948648 |
|---|---|
| Provider Enumeration Date | 12/21/2015 |
| Last Update Date | 11/01/2024 |
| Certification Date | 11/01/2024 |
| Medicare PECOS PAC ID | 4486099470 |
|---|---|
| Medicare Enrollment ID | O20240229001870 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770948648 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 907748 (Virginia) | Primary |
| 324500000X | Substance Abuse Rehabilitation Facility | (* (Not Available)) | Secondary |
| Provider Name | Christyn L Holley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1316601685 PECOS PAC ID: 4981059839 Enrollment ID: I20240403002670 |
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