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General NPI Number Information
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NPI Number | 1881132231
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Entity Type | Organization
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Legal Business Name | CMB HOLDINGS
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Dates
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Enumeration Date | 02/06/2017
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Last Update Date | 02/06/2017
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Provider Practice Location Address
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Address Line | 4420 FAIRFAX DR SUITE 100
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City | ARLINGTON
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State | VA
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Zip | 22203-1645
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Country | US
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Telephone | 703-436-8158
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Fax |
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Provider Business Mailing Address
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Address Line | 4420 FAIRFAX DR SUITE 100
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City | ARLINGTON
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State | VA
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Zip | 22203-1645
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. CHRISTOPHER BENNETT
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Credential |
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Telephone | 703-436-8158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | 2943-02-001
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License Number State | VA
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