MEDICARE: ASCEND BEHAVIORAL HEALTH VA 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	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1881553659
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASCEND BEHAVIORAL HEALTH VA LLC

Provider Business Mailing Address
First Line	:	8140 ZINFANDEL DR
Second Line	:
City	:	KERNERSVILLE
State	:	NC
Zip	:	27284-6716
Country	:	US
Telephone Number	:	276-201-3065
Fax Number	:	276-201-3065

Provider Business Practice Location Address
First Line	:	8140 ZINFANDEL DR
Second Line	:
City	:	KERNERSVILLE
State	:	NC
Zip	:	27284-6716
Country	:	US
Telephone Number	:	276-201-3065
Fax Number	:	276-201-3065

Authorized Official
Title or Position	:	ADMINISTRATION
Name	:	MARQUITA DIXON
Credential	:
Telephone Number	:	276-201-3065

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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