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General NPI Number Information
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NPI Number | 1659839793
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Entity Type | Organization
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Legal Business Name | ONE ON ONE ADDICTION AND RECOVERY SERVICES, INC.
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Dates
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Enumeration Date | 03/07/2019
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Last Update Date | 03/07/2019
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Provider Practice Location Address
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Address Line | 5538 MECHANICSVILLE TPKE
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City | MECHANICSVILLE
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State | VA
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Zip | 23111-4563
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Country | US
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Telephone | 804-615-4542
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 13066
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City | RICHMOND
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State | VA
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Zip | 23225-0066
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Country | US
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Telephone | 804-615-4542
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | NICOLE CHERISE THOMAS
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Credential |
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Telephone | 804-615-4542
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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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 | 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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