| Pasadena Villa Outpatient- Chantilly | |
|
14555 Avion Pkwy Ste 150 Chantilly VA 20151-1134 | |
| (703) 682-8057 | |
| Not Available |
| Full Name | Pasadena Villa Outpatient- Chantilly |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 14555 Avion Pkwy Ste 150, Chantilly, Virginia |
| Authorized Official Name and Position | Scott Sarnacke (CFO) |
| Authorized Official Contact | 6158648154 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pasadena Villa Outpatient- Chantilly 14555 Avion Pkwy Ste 150 Chantilly VA 20151-1134 Ph: () - | Pasadena Villa Outpatient- Chantilly 14555 Avion Pkwy Ste 150 Chantilly VA 20151-1134 Ph: (703) 682-8057 |
| NPI Number | 1336857275 |
|---|---|
| Provider Enumeration Date | 11/09/2022 |
| Last Update Date | 05/14/2024 |
| Certification Date | 05/14/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336857275 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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