Healthcare Provider Details

I. General information

NPI: 1841027984
Provider Name (Legal Business Name): MORANT BEHAVIORAL WELLNESS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2024
Last Update Date: 10/04/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 LOON CT
YORKTOWN VA
23692-2998
US

IV. Provider business mailing address

108 LOON CT
YORKTOWN VA
23692-2998
US

V. Phone/Fax

Practice location:
  • Phone: 757-469-0332
  • Fax:
Mailing address:
  • Phone: 757-469-0332
  • 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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. PATRICE MORANT
Title or Position: DIRECTOR
Credential:
Phone: 757-469-0332