| Elite Star Therapeutic Services Llc | |
|
4421 Dixie Hill Rd Apt 409 Fairfax VA 22030-9080 | |
| (703) 231-7727 | |
| Not Available |
| Full Name | Elite Star Therapeutic Services Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4421 Dixie Hill Rd Apt 409, Fairfax, Virginia |
| Authorized Official Name and Position | Ramla A Aden (CEO) |
| Authorized Official Contact | 7032317727 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elite Star Therapeutic Services Llc 4421 Dixie Hill Rd Apt 409 Fairfax VA 22030-9080 Ph: (703) 231-7727 | Elite Star Therapeutic Services Llc 4421 Dixie Hill Rd Apt 409 Fairfax VA 22030-9080 Ph: (703) 231-7727 |
| NPI Number | 1689448540 |
|---|---|
| Provider Enumeration Date | 11/10/2023 |
| Last Update Date | 11/10/2023 |
| Certification Date | 11/10/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689448540 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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