| Victoria Transcultural Clinical Center Llc | |
|
3541 Chain Bridge Rd Suite 204 Fairfax VA 22030-2793 | |
| (703) 218-6599 | |
| (703) 218-2012 |
| Full Name | Victoria Transcultural Clinical Center Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 3541 Chain Bridge Rd, Fairfax, Virginia |
| Authorized Official Name and Position | Ignacio Basauri (ADMINISTRATIVE DIRECTOR) |
| Authorized Official Contact | 7032186599 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Victoria Transcultural Clinical Center Llc Po Box 3351 Fairfax VA 22038-3351 Ph: (703) 218-6599 | Victoria Transcultural Clinical Center Llc 3541 Chain Bridge Rd Suite 204 Fairfax VA 22030-2793 Ph: (703) 218-6599 |
| NPI Number | 1811089014 |
|---|---|
| Provider Enumeration Date | 09/28/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811089014 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 45005001 45007004 (Virginia) | Primary |
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