| Tiny Tadpoles Behavioral Services, Llc | |
|
14060 Big Crest Ln Apt 403 Woodbridge VA 22191-5537 | |
| (570) 713-9112 | |
| Not Available |
| Full Name | Tiny Tadpoles Behavioral Services, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 14060 Big Crest Ln Apt 403, Woodbridge, Virginia |
| Authorized Official Name and Position | Recairdo Demetrius Mangrum (DIRECTOR) |
| Authorized Official Contact | 5707139112 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tiny Tadpoles Behavioral Services, Llc 14060 Big Crest Ln Apt 403 Woodbridge VA 22191-5537 Ph: (570) 713-9112 | Tiny Tadpoles Behavioral Services, Llc 14060 Big Crest Ln Apt 403 Woodbridge VA 22191-5537 Ph: (570) 713-9112 |
| NPI Number | 1760828321 |
|---|---|
| Provider Enumeration Date | 05/21/2013 |
| Last Update Date | 05/21/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760828321 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Virginia) | Primary |
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