Potomac Shores Mental Health And Wellness Center

LBN: Potomac Shores Mental Health And Wellness Center
Potomac Shores Mental Health And Wellness Center is an health care organization with primary practice located at 13000 Harbor Center Dr Ste 103 , Woodbridge VA 22192-2847. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is the primary health care specialty. Potomac Shores Mental Health And Wellness Center can be contacted via phone (703) 977-6556, or through Ayoola, Ebunola Moira via phone (202) 809-3550.

Contact Information

Primary practice address
13000 Harbor Center Dr Ste 103 Woodbridge VA 22192-2847
Phone: (703) 977-6556
Fax: (703) 997-1490
Website:
Map and Directions
Authorized official contact:
Name: Ayoola, Ebunola Moira PHMNP
Phone: (202) 809-3550

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X

Profile Details

NPI number 1902562507
LBN Legal business name Potomac Shores Mental Health And Wellness Center
DBA Doing business as
Authorized official Ayoola, Ebunola Moira PHMNP
Entity Organization
Organization subpart 1 No
Enumeration date Nov 9th, 2021
Last updated Apr 19th, 2024 - about 8 months 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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