Healthcare Provider Details

I. General information

NPI: 1447123245
Provider Name (Legal Business Name): RECOVERY CENTERS OF AMERICA OUTPATIENT SERVICES VA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3022 WILLIAMS DR STE 301
FAIRFAX VA
22031-4600
US

IV. Provider business mailing address

2201 RENAISSANCE BLVD FL 3
KING OF PRUSSIA PA
19406-2709
US

V. Phone/Fax

Practice location:
  • Phone: 800-732-6837
  • Fax:
Mailing address:
  • Phone: 484-971-6409
  • Fax: 484-393-4096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. MARWAN ASMAR
Title or Position: CONTRACTS PAYOR MANAGER
Credential: N/A
Phone: 484-633-1228