| Recovery 180 Virginia Llc | |
|
6791 James Madison Hwy Warrenton VA 20187-9534 | |
| (443) 289-8606 | |
| Not Available |
| Full Name | Recovery 180 Virginia Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6791 James Madison Hwy, Warrenton, Virginia |
| Authorized Official Name and Position | Jessie Costley (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 4438396928 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Recovery 180 Virginia Llc 1100 Business Pkwy S Ste 1 Westminster MD 21157-3048 Ph: (443) 839-6928 | Recovery 180 Virginia Llc 6791 James Madison Hwy Warrenton VA 20187-9534 Ph: (443) 289-8606 |
| NPI Number | 1326800798 |
|---|---|
| Provider Enumeration Date | 01/30/2024 |
| Last Update Date | 01/30/2024 |
| Certification Date | 01/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326800798 | NPI | - | NPPES |
| 8228-02-033 | Other | VA | FACILITY LICENSE |
| 8228-02-035 | Other | VA | FACILITY LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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