Provenance Substance Abuse & Wellness Centers Llc

LBN: Provenance Substance Abuse & Wellness Centers Llc
Provenance Substance Abuse & Wellness Centers Llc is an health care organization with primary practice located at 4870 Sadler Rd Pmb #8903 Suite 300, Glen Allen VA 23060. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder. Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) is the primary health care specialty. Provenance Substance Abuse & Wellness Centers Llc can be contacted via phone (480) 980-2749, or through Newburn, Devolis via phone (480) 980-2749.

Contact Information

Primary practice address
4870 Sadler Rd Pmb #8903 Suite 300 Glen Allen VA 23060
Phone: (480) 980-2749
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Newburn, Devolis
Phone: (480) 980-2749

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X
Ambulatory Health Care Facilities / Rehabilitation, Substance Use Disorder 261QR0405X

Profile Details

NPI number 1649976945
LBN Legal business name Provenance Substance Abuse & Wellness Centers Llc
DBA Doing business as
Authorized official Newburn, Devolis
Entity Organization
Organization subpart 1 No
Enumeration date Feb 7th, 2023
Last updated Aug 7th, 2023 - about 2 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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