| Leesburg Community Church | |
|
815 Lee Ave Sw Ste B Leesburg VA 20175-3416 | |
| (703) 777-2209 | |
| Not Available |
| Full Name | Leesburg Community Church |
|---|---|
| Speciality | Counselor - Professional |
| Location | 815 Lee Ave Sw Ste B, Leesburg, Virginia |
| Authorized Official Name and Position | Timothy J Teague (DIRECTOR) |
| Authorized Official Contact | 7037772209 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leesburg Community Church 835 Lee Ave Sw Leesburg VA 20175-3416 Ph: (703) 777-2209 | Leesburg Community Church 815 Lee Ave Sw Ste B Leesburg VA 20175-3416 Ph: (703) 777-2209 |
| NPI Number | 1013206200 |
|---|---|
| Provider Enumeration Date | 03/29/2011 |
| Last Update Date | 03/29/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013206200 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 0701001459 (Virginia) | Primary |
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