| Dba | |
|
4419 Heidi Ct Midlothian VA 23112-3265 | |
| (804) 221-8362 | |
| Not Available |
| Full Name | Dba |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4419 Heidi Ct, Midlothian, Virginia |
| Authorized Official Name and Position | Dolapo Victoria Akadiri (CEO) |
| Authorized Official Contact | 8042218362 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dba 4419 Heidi Ct Midlothian VA 23112-3265 Ph: (804) 221-8362 | Dba 4419 Heidi Ct Midlothian VA 23112-3265 Ph: (804) 221-8362 |
| NPI Number | 1053186353 |
|---|---|
| Provider Enumeration Date | 11/17/2023 |
| Last Update Date | 08/26/2024 |
| Certification Date | 08/26/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053186353 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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