| Riverside Mental Health Llc | |
|
7011 Calamo St #105 Springfield VA 22150 | |
| (703) 569-8028 | |
| (703) 569-8085 |
| Full Name | Riverside Mental Health Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 7011 Calamo St, Springfield, Virginia |
| Authorized Official Name and Position | Benjamin Adyson Adenwale (MEDICAL DIRECTOR MD) |
| Authorized Official Contact | 7035698028 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Riverside Mental Health Llc Po Box 8057 Alexandria VA 22306-8057 Ph: () - | Riverside Mental Health Llc 7011 Calamo St #105 Springfield VA 22150 Ph: (703) 569-8028 |
| NPI Number | 1821015264 |
|---|---|
| Provider Enumeration Date | 07/15/2006 |
| Last Update Date | 01/17/2018 |
| Medicare PECOS PAC ID | 2961469176 |
|---|---|
| Medicare Enrollment ID | O20041220000115 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821015264 | NPI | - | NPPES |
| Provider Name | Benjamin A Adewale |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790702132 PECOS PAC ID: 0345229571 Enrollment ID: I20040720000320 |
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