Organization
VIP THERAPY & WELLNESS SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY JACKSON (CEO)
(951) 977-1388
Entity
Organization
Contact information
Practice address
137 NATIONAL PLZ STE 300, OXON HILL, MD 20745-1153
(951) 977-1388
Mailing address
1709 DUNNINGTON PL, DUMFRIES, VA 22026-2871
(301) 395-9033
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
01/03/2024
Last updated
01/03/2024
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