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General NPI Number Information
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NPI Number | 1275173353
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC TREATMENT CENTER
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Dates
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Enumeration Date | 01/07/2020
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Last Update Date | 01/07/2020
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Provider Practice Location Address
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Address Line | 302 TURNER RD STE D
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23225-6433
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Country | US
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Telephone | 804-556-8882
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Fax | 804-556-8884
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Provider Business Mailing Address
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Address Line | 302 TURNER RD STE D
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23225-6433
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Country | US
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Telephone | 804-556-8882
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Fax | 804-556-8884
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Authorized Official
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Title or Position | CEO
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Name | LEKEISHA HITE
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Credential | PSYD
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Telephone | 804-556-8882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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