MEDICARE: VOYAGE BEHAVIORAL HEALTH, LLC

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1407417835
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VOYAGE BEHAVIORAL HEALTH, LLC

Provider Business Mailing Address
First Line	:	5704 GROVE FOREST RD
Second Line	:
City	:	MIDLOTHIAN
State	:	VA
Zip	:	23112-2369
Country	:	US
Telephone Number	:	817-914-0825
Fax Number	:

Provider Business Practice Location Address
First Line	:	5704 GROVE FOREST RD
Second Line	:
City	:	MIDLOTHIAN
State	:	VA
Zip	:	23112-2369
Country	:	US
Telephone Number	:	817-914-0825
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. SARAH E WRIGHT
Credential	:	M.ED., PBSF
Telephone Number	:	817-914-0825

Provider Enumeration Date	:	06/26/2019
Last Update Date	:	06/26/2019

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