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General NPI Number Information
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NPI Number | 1851107544
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Entity Type | Organization
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Legal Business Name | RCH BRAIN & MIND CENTER VA, PC
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Dates
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Enumeration Date | 12/06/2024
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 8316 ARLINGTON BLVD STE 420
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City | FAIRFAX
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State | VA
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Zip | 22031-5216
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Country | US
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Telephone | 571-307-2741
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Fax |
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Provider Business Mailing Address
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Address Line | 1307 8TH AVE STE 403
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City | FORT WORTH
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State | TX
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Zip | 76104-4143
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Country | US
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Telephone | 682-394-3500
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Fax | 817-862-7238
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Authorized Official
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Title or Position | FINANCIAL ANAYLST
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Name | DANIELLE WILLIAMS
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Credential |
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Telephone | 817-629-0752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty 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 | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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