Organization
AQUILA RECOVERY OF VIRGINIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT R COFFEY (OWNER)
(703) 464-5122
Entity
Organization
Contact information
Practice address
425 CARLISLE DR STE B, HERNDON, VA 20170-5618
(703) 464-5122
Mailing address
425 CARLISLE DR STE B, HERNDON, VA 20170-5618
(703) 464-5122
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/28/2019
Last updated
10/28/2019
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