| Dynasty Wellness, Llc | |
|
976 Forest Lake Dr Apt 304 Virginia Beach VA 23464-3636 | |
| (757) 630-1493 | |
| Not Available |
| Full Name | Dynasty Wellness, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 976 Forest Lake Dr Apt 304, Virginia Beach, Virginia |
| Authorized Official Name and Position | Joey Mnaning (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7576301493 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dynasty Wellness, Llc 976 Forest Lake Dr Apt 304 Virginia Beach VA 23464-3636 Ph: (757) 630-1493 | Dynasty Wellness, Llc 976 Forest Lake Dr Apt 304 Virginia Beach VA 23464-3636 Ph: (757) 630-1493 |
| NPI Number | 1659151660 |
|---|---|
| Provider Enumeration Date | 10/05/2023 |
| Last Update Date | 10/05/2023 |
| Certification Date | 10/05/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659151660 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 261QD1600X | Clinic/center - Developmental Disabilities | (* (Not Available)) | Secondary |
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