| Clementine Twin Lakes, Llc | |
|
13215 Twin Lakes Dr Clifton VA 20124-1215 | |
| (305) 663-1876 | |
| (914) 479-5490 |
| Full Name | Clementine Twin Lakes, Llc |
|---|---|
| Speciality | Psychiatric Residential Treatment Facility |
| Location | 13215 Twin Lakes Dr, Clifton, Virginia |
| Authorized Official Name and Position | Mike Bagley (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 3056631876 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clementine Twin Lakes, Llc 6100 Sw 76th St South Miami FL 33143-5002 Ph: (305) 663-1876 | Clementine Twin Lakes, Llc 13215 Twin Lakes Dr Clifton VA 20124-1215 Ph: (305) 663-1876 |
| NPI Number | 1801375118 |
|---|---|
| Provider Enumeration Date | 08/08/2018 |
| Last Update Date | 10/17/2024 |
| Certification Date | 10/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801375118 | NPI | - | NPPES |
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