| Green Box Aba, Pllc | |
|
6216 Old Keene Mill Ct Springfield VA 22152-2323 | |
| (571) 297-4308 | |
| (703) 992-0405 |
| Full Name | Green Box Aba, Pllc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6216 Old Keene Mill Ct, Springfield, Virginia |
| Authorized Official Name and Position | Christopher Richardson (CHIEF OPERATING OFFICER) |
| Authorized Official Contact | 5712974308 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Green Box Aba, Pllc 7704 Gromwell Ct Springfield VA 22152-3134 Ph: (703) 975-2791 | Green Box Aba, Pllc 6216 Old Keene Mill Ct Springfield VA 22152-2323 Ph: (571) 297-4308 |
| NPI Number | 1316342934 |
|---|---|
| Provider Enumeration Date | 10/24/2014 |
| Last Update Date | 09/14/2022 |
| Certification Date | 09/06/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316342934 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0133000288 (Virginia) | Primary |
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