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General NPI Number Information
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NPI Number | 1659837821
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Entity Type | Organization
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Legal Business Name | CAVERY TREATMENT CENTER
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Dates
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Enumeration Date | 02/13/2019
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 14330 GIDEON DR STE B
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City | WOODBRIDGE
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State | VA
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Zip | 22192-4640
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Country | US
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Telephone | 571-408-6800
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Fax |
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Provider Business Mailing Address
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Address Line | 14610 SULKY RUN CT
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City | NOKESVILLE
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State | VA
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Zip | 20181-2953
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Country | US
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Telephone | 910-525-8017
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Fax |
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Authorized Official
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Title or Position | OWNER/FNP
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Name | CHRISTY M HARSHBERGER
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Credential | FNP-C
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Telephone | 571-408-6800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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