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Organization
PRINCE WILLIAM COUNTY COMMUNITY SERVICES BOARD
Active
Organization
PRINCE WILLIAM COUNTY COMMUNITY SERVICES BOARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANSAR SHAND (MANAGER)
(703) 792-7800
Entity
Organization
Contact information
Practice address
7969 ASHTON AVE, MANASSAS, VA 20109-2885
(703) 792-7800
(703) 792-5699
Mailing address
7969 ASHTON AVE, MANASSAS, VA 20109-2885
(703) 792-7800
(703) 792-5699
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004945247
—
VA
05
—
004978277
—
VA
01
—
210245
BLUE CROSS BLUE SHIELD
VA
Enumeration date
09/27/2006
Last updated
10/30/2013
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