Organization
MID-ATLANTIC BEHAVIORAL SERVICES , LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ITALIA TALLEY (OWNER)
(310) 270-0968
Entity
Organization
Contact information
Practice address
11923 CENTRE ST STE B1, CHESTER, VA 23831-1702
(310) 270-0968
Mailing address
11923 CENTRE ST STE B1, CHESTER, VA 23831-1702
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
08/23/2023
Last updated
05/05/2026
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