Healthcare Provider Details

I. General information

NPI: 1295359941
Provider Name (Legal Business Name): MET-R INTEGRATED HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2020
Last Update Date: 01/20/2022
Certification Date: 01/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 RICKETTS DR
WINCHESTER VA
22601-3676
US

IV. Provider business mailing address

30 RICKETTS DR
WINCHESTER VA
22601-3676
US

V. Phone/Fax

Practice location:
  • Phone: 540-535-1112
  • Fax:
Mailing address:
  • Phone: 540-535-1112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EVELYN PUIG
Title or Position: PRESIDENT
Credential:
Phone: 540-535-1112