| Maximo Delacruz Centro D Salud Mental Llc | |
|
31 Ontell Ct Stafford VA 22554-1566 | |
| (571) 572-0050 | |
| (888) 315-4281 |
| Full Name | Maximo Delacruz Centro D Salud Mental Llc |
|---|---|
| Speciality | Psychologist - Clinical Child & Adolescent |
| Location | 31 Ontell Ct, Stafford, Virginia |
| Authorized Official Name and Position | Maximo De La Cruz (OWNER/DIRECTOR) |
| Authorized Official Contact | 5715720050 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maximo Delacruz Centro D Salud Mental Llc 31 Ontell Ct Stafford VA 22554-1566 Ph: (571) 572-0050 | Maximo Delacruz Centro D Salud Mental Llc 31 Ontell Ct Stafford VA 22554-1566 Ph: (571) 572-0050 |
| NPI Number | 1205607744 |
|---|---|
| Provider Enumeration Date | 01/12/2024 |
| Last Update Date | 01/12/2024 |
| Certification Date | 01/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205607744 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | (* (Not Available)) | Primary |
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