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General NPI Number Information
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NPI Number | 1033899406
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Entity Type | Organization
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Legal Business Name | A VILLAGE WELLNESS CENTER LLC
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Dates
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Enumeration Date | 07/20/2023
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 804 PERSHING DR STE 202
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City | SILVER SPRING
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State | MD
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Zip | 20910-4439
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Country | US
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Telephone | 301-328-7162
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Fax |
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Provider Business Mailing Address
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Address Line | 804 PERSHING DR STE 202
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City | SILVER SPRING
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State | MD
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Zip | 20910-4439
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Country | US
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Telephone | 301-328-7162
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. CHRISTOPHER LANGLEY
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Credential |
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Telephone | 202-578-0908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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