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General NPI Number Information
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NPI Number | 1710449327
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Entity Type | Organization
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Legal Business Name | KEMET HEALTH ONE LLC
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Dates
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Enumeration Date | 04/02/2019
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 5413 BACKLICK RD STE A
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City | SPRINGFIELD
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State | VA
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Zip | 22151-3915
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Country | US
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Telephone | 412-508-7524
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Fax |
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Provider Business Mailing Address
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Address Line | 169 MADISON AVE # 11841
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City | NEW YORK
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State | NY
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Zip | 10016-5101
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Country | US
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Telephone | 703-256-1600
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ANDREW SCHNECK
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Credential |
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Telephone | 412-508-7524
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health 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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health 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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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