Healthcare Provider Details

I. General information

NPI: 1700285087
Provider Name (Legal Business Name): NATIONAL CAPITAL TREATMENT AND RECOVERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2014
Last Update Date: 03/23/2023
Certification Date: 03/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N GLEBE RD SUITE 104
ARLINGTON VA
22203-3728
US

IV. Provider business mailing address

200 N GLEBE RD SUITE 104
ARLINGTON VA
22203-3728
US

V. Phone/Fax

Practice location:
  • Phone: 703-841-0703
  • Fax: 703-243-0975
Mailing address:
  • Phone: 703-841-0703
  • Fax: 703-243-0975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number122-02-001, 021&004
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. SUSAN HARGREAVES
Title or Position: VICE PRESIDENT / DIRECTOR OF FINANC
Credential:
Phone: 703-841-0703