MEDICARE: WINCHESTER ADDICTION SERVICES PLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1003099938
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WINCHESTER ADDICTION SERVICES PLC

Provider Business Mailing Address
First Line	:	3042 VALLEY AVE. SUITE 110
Second Line	:
City	:	WINCHESTER
State	:	VA
Zip	:	22601-2755
Country	:	US
Telephone Number	:	540-450-2206
Fax Number	:	540-450-1546

Provider Business Practice Location Address
First Line	:	3042 VALLEY AVE. SUITE 110
Second Line	:
City	:	WINCHESTER
State	:	VA
Zip	:	22601-2755
Country	:	US
Telephone Number	:	540-450-2206
Fax Number	:	540-450-1546

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN F LINDSEY
Credential	:	LCSW, CSAC
Telephone Number	:	540-450-2206

Provider Enumeration Date	:	12/13/2007
Last Update Date	:	07/10/2019

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