Healthcare Provider Details

I. General information

NPI: 1669328613
Provider Name (Legal Business Name): AHENSA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18749 UPPER MEADOW DR
LEESBURG VA
20176-1802
US

IV. Provider business mailing address

18749 UPPER MEADOW DR
LEESBURG VA
20176-1802
US

V. Phone/Fax

Practice location:
  • Phone: 847-668-8405
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CHARLES KWAKU AWOTWI
Title or Position: COO
Credential: PMP
Phone: 847-668-8405