Healthcare Provider Details

I. General information

NPI: 1558110817
Provider Name (Legal Business Name): BALANCED HORIZONS TREATMENT CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2024
Last Update Date: 05/17/2024
Certification Date: 05/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2270 VALOR DR
WINCHESTER VA
22601-3699
US

IV. Provider business mailing address

2270 VALOR DR
WINCHESTER VA
22601-3699
US

V. Phone/Fax

Practice location:
  • Phone: 703-678-5186
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: GERALD LEE
Title or Position: MEDICAL DIRECTOR
Credential:
Phone: 703-678-5186