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Organization
WILLIAMSVILLE WELLNESS PHP
Active
Organization
WILLIAMSVILLE WELLNESS PHP
Active
Parent organization
WILLIAMSVILLE WELLNESS, LLC
Other names
Williamsville Wellness Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
WILLIAMSVILLE WELLNESS, LLC
Authorized official
MR. ROBERT WOODROW CABANISS JR. (EXECUTIVE DIRECTOR)
(804) 559-9959
Entity
Organization
Contact information
Practice address
10515 CABANISS LN, HANOVER, VA 23069-1840
(804) 559-9959
(804) 559-9613
Mailing address
10515 CABANISS LN, HANOVER, VA 23069-1840
(804) 559-9959
(804) 559-9613
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
994
VA
Other
Enumeration date
10/23/2015
Last updated
10/23/2015
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