# ADDICTION WELLNESS CENTER VA

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ADDICTION WELLNESS CENTER VA
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1396602793
- **Legal business name:** ADDICTION WELLNESS CENTER VA
- **Authorized official:** JESSIE COSTLEY (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (540) 655-2936

## Contact information

- **Practice address:** 824 JOHN MARSHALL HWY STE 203, FRONT ROYAL, VA 22630-3744
- **Practice address phone:** (540) 655-2936
- **Practice address fax:** (540) 736-4371
- **Mailing address:** 1100 BUSINESS PKWY S STE 1, WESTMINSTER, MD 21157-3048
- **Mailing address phone:** (540) 655-2936
- **Mailing address fax:** (540) 736-4371

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 01/07/2026
- **Last updated:** 01/30/2026