MANASSAS ADDICTION CENTER LLC NPI 1225692015

NPI Information

NPI: 1225692015
Provider Name: MANASSAS ADDICTION CENTER LLC
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

CLIA Number: 49D2202946

Address:
9001 DIGGES RD STE 104
MANASSAS, VA
ZIP 20110
Phone: (703) 239-3602
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MANASSAS ADDICTION CENTER LLC is a rehabilitation and substance use disorder clinic center in Manassas, VA. MANASSAS ADDICTION CENTER LLC NPI is 1225692015. The provider is registered as an organization entity type.

The provider's business location address is:

9001 DIGGES RD STE 104
MANASSAS, VA
ZIP 20110-414
Phone: (703) 239-3602
Fax: (855) 888-8410

The provider's authorized official is Nancye Lynn Sadler .
The authorized official title is President and has the following contact phone number (703) 239-3602.

The CLIA number assigned to this NPI record is 49D2202946 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/26/2019 and was last updated on 7/23/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1508818790	MEDICAID	VIRGINIA
2	8951641	MEDICAID	VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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