Clementine Twin Lakes, Llc

LBN: Clementine Twin Lakes, Llc
Clementine Twin Lakes, Llc is an health care organization with primary practice located at 11329 Henderson Rd , Fairfax Station VA 22039-2314. The organization recently has only one registered license in Ambulatory Health Care Facilities / Adolescent and Children Mental Health, which is considered as the primary health care specialty. Clementine Twin Lakes, Llc can be contacted via phone (305) 663-1876, or through Bagley, Mike via phone (305) 663-1876.

Contact Information

Primary practice address
11329 Henderson Rd Fairfax Station VA 22039-2314
Phone: (305) 663-1876
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Bagley, Mike
Phone: (305) 663-1876

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Adolescent and Children Mental Health 261QM0855X

Profile Details

NPI number 1689269250
LBN Legal business name Clementine Twin Lakes, Llc
DBA Doing business as
Authorized official Bagley, Mike
Entity Organization
Organization subpart 1 No
Enumeration date Mar 5th, 2021
Last updated Mar 5th, 2021 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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