| Therapeutic Alliance Llc | |
|
7771 Ashton Ave Manassas VA 20109-2879 | |
| (703) 492-2686 | |
| (866) 499-8840 |
| Full Name | Therapeutic Alliance Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 7771 Ashton Ave, Manassas, Virginia |
| Authorized Official Name and Position | Alkesh Patel (CEO) |
| Authorized Official Contact | 7034922686 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Therapeutic Alliance Llc Po Box 71807 Henrico VA 23255-1807 Ph: (877) 794-2284 | Therapeutic Alliance Llc 7771 Ashton Ave Manassas VA 20109-2879 Ph: (703) 492-2686 |
| NPI Number | 1497185680 |
|---|---|
| Provider Enumeration Date | 11/25/2013 |
| Last Update Date | 05/07/2020 |
| Certification Date | 05/07/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497185680 | NPI | - | NPPES |
| 154005001 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 0701004701 (Virginia) | Primary |
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