Provider Demographics
NPI:1407691330
Name:EILAND BEHAVIORAL MEDICINE, PLLC
Entity type:Organization
Organization Name:EILAND BEHAVIORAL MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHYSICIAN ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:SETH
Authorized Official - Middle Name:
Authorized Official - Last Name:EILAND
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C, CAQ-PSYCH
Authorized Official - Phone:870-918-9792
Mailing Address - Street 1:277 S WASHINGTON ST STE 210
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-3672
Mailing Address - Country:US
Mailing Address - Phone:870-918-9792
Mailing Address - Fax:949-703-7069
Practice Address - Street 1:277 S WASHINGTON ST STE 210
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-3672
Practice Address - Country:US
Practice Address - Phone:870-918-9792
Practice Address - Fax:949-703-7069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-01
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty