Organization Name: | COMMONWEALTH BEHAVIORAL HEALTH, INC. |
NPI Number: | 1003184144 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PASCAL THEBAUD (DIRECTOR) |
Mailing Address: | 13356 Midlothian Tpke Suite 202 Midlothian |
State: | VA US |
Postal Code: | 231134210 |
Phone Number: | 8047211720 |
Fax Number: | 8042142177 |
NPI Enumeration Date: | 12/04/2011 |
NPI Last Update Date: | 12/04/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 0701004809 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |