Provider Demographics
NPI:1699135244
Name:CENTER FOR BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:CENTER FOR BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:HUSAM
Authorized Official - Middle Name:K
Authorized Official - Last Name:ALATHARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-492-5584
Mailing Address - Street 1:13601 OFFICE PL STE 201
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-4213
Mailing Address - Country:US
Mailing Address - Phone:703-492-2924
Mailing Address - Fax:
Practice Address - Street 1:13601 OFFICE PL STE 201
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-4213
Practice Address - Country:US
Practice Address - Phone:703-492-8939
Practice Address - Fax:703-763-3006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-24
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder