Organization
BELLWETHER BEHAVIORAL OF VIRGINIA, LLC
Active
Parent organization
GI ADVO OPCO, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GI ADVO OPCO, LLC
Authorized official
KATHLEEN SHEA (CHIEF FINANCIAL OFFICER)
(302) 365-8050
Entity
Organization
Contact information
Practice address
9932 MAIN ST, FAIRFAX, VA 22031-3901
(302) 365-8050
Mailing address
2520 WRANGLE HILL RD, SUITE 200, BEAR, DE 19701-3849
(302) 365-8050
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
0701006290
VA
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
2666
VA
Other
Enumeration date
09/08/2015
Last updated
08/18/2017
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