| Provenance Substance Abuse & Wellness Centers Llc | |
|
4870 Sadler Rd Pmb #8903 Suite 300 Glen Allen VA 23060 | |
| (480) 442-9819 | |
| Not Available |
| Full Name | Provenance Substance Abuse & Wellness Centers Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4870 Sadler Rd Pmb #8903, Glen Allen, Virginia |
| Authorized Official Name and Position | Devolis Newburn (OWNER) |
| Authorized Official Contact | 4804429819 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Provenance Substance Abuse & Wellness Centers Llc 4870 Sadler Rd Pmb #8903 Suite 300 Glen Allen VA 23060 Ph: () - | Provenance Substance Abuse & Wellness Centers Llc 4870 Sadler Rd Pmb #8903 Suite 300 Glen Allen VA 23060 Ph: (480) 442-9819 |
| NPI Number | 1649976945 |
|---|---|
| Provider Enumeration Date | 02/07/2023 |
| Last Update Date | 08/20/2024 |
| Certification Date | 08/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649976945 | NPI | - | NPPES |
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