Organization
BURGESS BEHAVIORAL HEALTH ALTERNATIVES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THARTA RENA KING (NURSE PRACTITIONER)
(804) 787-0408
Entity
Organization
Contact information
Practice address
740 JESSIE DUPONT MEMORIAL HWY, BURGESS, VA 22432
(804) 453-3290
(804) 453-3492
Mailing address
110 N ROBINSON ST STE 200, RICHMOND, VA 23220-4460
(804) 453-3290
(804) 453-3492
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/05/2022
Last updated
04/11/2022
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