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NPI Code Detail

MEDICARE: PHILLIPS PROGRAMS

MEDICARE: PHILLIPS PROGRAMS
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
1251S00000XCommunity/Behavioral Health Agency135VA

General Provider Information

NPI Number : 1659453231
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHILLIPS PROGRAMS
Provider Business Mailing Address
First Line : 7010 BRADDOCK RD
Second Line :
City : ANNANDALE
State : VA
Zip : 22003-6006
Country : US
Telephone Number : 703-658-9054
Fax Number : 703-658-9056
Provider Business Practice Location Address
First Line : 7010 BRADDOCK RD
Second Line :
City : ANNANDALE
State : VA
Zip : 22003-6006
Country : US
Telephone Number : 703-658-9054
Fax Number : 703-658-9056
Authorized Official
Title or Position : PROGRAM MANAGER
Name : MS. SANDRA PORTEOUS
Credential : M.A.
Telephone Number : 703-658-9054
Provider Enumeration Date : 10/20/2006
Last Update Date : 08/22/2020

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Directions to “PHILLIPS PROGRAMS ” Practice Location

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