Provider Demographics
NPI:1699298422
Name:ANDREWS WELLNESS CENTER
Entity type:Organization
Organization Name:ANDREWS WELLNESS CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:804-520-7246
Mailing Address - Street 1:2200 BOULEVARD STE C
Mailing Address - Street 2:
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-2305
Mailing Address - Country:US
Mailing Address - Phone:804-520-7246
Mailing Address - Fax:804-520-6311
Practice Address - Street 1:2200 BOULEVARD STE C
Practice Address - Street 2:
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-2305
Practice Address - Country:US
Practice Address - Phone:804-520-7246
Practice Address - Fax:804-520-6311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1346600640OtherGROUP NPI
VA0104557295OtherDEPT. OF HEALTH PROFESSIONALS