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Organization
VIRGINIA RECOVERY LIVING CORPORATION
Active
Organization
VIRGINIA RECOVERY LIVING CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHANTA JAH (CO-OWNER)
(540) 254-0877
Entity
Organization
Contact information
Practice address
3130 GOLANSKY BLVD, WOODBRIDGE, VA 22192-4268
(540) 254-0877
(703) 649-0129
Mailing address
3130 GOLANSKY BLVD, WOODBRIDGE, VA 22192-4268
(540) 254-0877
(703) 649-0129
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
NULL
251B00000X
Case Management Agency
—
NULL
251E00000X
Home Health Agency
—
NULL
251F00000X
Home Infusion Agency
—
NULL
251J00000X
Nursing Care Agency
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
253J00000X
Foster Care Agency
—
NULL
253Z00000X
In Home Supportive Care Agency
—
NULL
261Q00000X
Clinic/Center
—
NULL
261QD1600X
Developmental Disabilities Clinic/Center
—
NULL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
NULL
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
NULL
323P00000X
Psychiatric Residential Treatment Facility
—
NULL
324500000X
Substance Abuse Rehabilitation Facility
—
NULL
363LA2200X
Adult Health Nurse Practitioner
Primary
—
NULL
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/13/2026
Last updated
03/13/2026
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