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General NPI Number Information
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NPI Number | 1720159064
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Entity Type | Organization
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Legal Business Name | VIAQUEST BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 11/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1170 S STATE ST BOX 729
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City | EPHRATA
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State | PA
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Zip | 17522-2601
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Country | US
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Telephone | 800-441-7345
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Fax |
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Provider Business Mailing Address
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Address Line | 525 METRO PL N SUITE 450
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City | DUBLIN
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State | OH
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Zip | 43017-5342
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Country | US
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Telephone | 800-645-3267
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Fax |
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | MR. RICH JOHNSON
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Credential |
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Telephone | 800-645-9267
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 323P00000X
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Taxonomy Name | Psychiatric Residential Treatment Facility
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License Number | 306820
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License Number State | PA
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