| R4 Enterprise Llc | |
|
39344 John Mosby Hwy Ste 346 Aldie VA 20105-2000 | |
| (703) 375-9396 | |
| Not Available |
| Full Name | R4 Enterprise Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 39344 John Mosby Hwy Ste 346, Aldie, Virginia |
| Authorized Official Name and Position | Ashley Rushing (OWNER/CLINICAL DIRECTOR) |
| Authorized Official Contact | 7037286599 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| R4 Enterprise Llc 39344 John Mosby Hwy Ste 346 Aldie VA 20105-2000 Ph: (703) 375-9396 | R4 Enterprise Llc 39344 John Mosby Hwy Ste 346 Aldie VA 20105-2000 Ph: (703) 375-9396 |
| NPI Number | 1255115481 |
|---|---|
| Provider Enumeration Date | 08/21/2023 |
| Last Update Date | 08/21/2023 |
| Certification Date | 08/20/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255115481 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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