| Tysons Mental Health Center Llc | |
|
450 West Broad Street Suite 304 Falls Church VA 22046-3318 | |
| (703) 270-5847 | |
| (703) 270-5848 |
| Full Name | Tysons Mental Health Center Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 450 West Broad Street, Falls Church, Virginia |
| Authorized Official Name and Position | Mehdi Ebrahimi Boroumand (MEMBER/MANAGER) |
| Authorized Official Contact | 3013774626 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tysons Mental Health Center Llc 450 West Broad Street Suite 304 Falls Church VA 22046-3318 Ph: (703) 270-5847 | Tysons Mental Health Center Llc 450 West Broad Street Suite 304 Falls Church VA 22046-3318 Ph: (703) 270-5847 |
| NPI Number | 1861983009 |
|---|---|
| Provider Enumeration Date | 05/23/2018 |
| Last Update Date | 05/23/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861983009 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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