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General NPI Number Information
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NPI Number | 1528812898
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Entity Type | Organization
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Legal Business Name | BEST LIFE BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 04/15/2024
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Last Update Date | 04/15/2024
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Provider Practice Location Address
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Address Line | 11140 ROCKVILLE PIKE STE 718
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City | ROCKVILLE
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State | MD
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Zip | 20852-3106
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Country | US
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Telephone | 301-579-0223
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Fax |
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Provider Business Mailing Address
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Address Line | 11140 ROCKVILLE PIKE STE 718
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City | ROCKVILLE
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State | MD
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Zip | 20852-3106
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Country | US
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Telephone | 301-579-0223
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | JONATHAN WHITEN
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Credential |
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Telephone | 301-579-0223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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