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General NPI Number Information
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NPI Number | 1003225780
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Entity Type | Organization
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Legal Business Name | ADDICTION ALLIES, LLC
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Dates
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Enumeration Date | 08/07/2014
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Last Update Date | 01/10/2020
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Provider Practice Location Address
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Address Line | 631 BERKMAR CIR
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901-1464
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Country | US
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Telephone | 434-770-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 631 BERKMAR CIR
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901-1464
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Country | US
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Telephone | 434-770-1000
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | NOEL B JEWELL
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Credential | MD
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Telephone | 304-497-0500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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