Organization
ADDICTION WELLNESS CENTER VA
Active
Parent organization
ADDICTION WELLNESS CENTER VA
Organization subpart
Yes
Provider details
NPI number
Legal business name
ADDICTION WELLNESS CENTER VA
Authorized official
JESSIE COSTLEY (CREDENTIALING SPECIALIST)
(540) 655-2936
Entity
Organization
Contact information
Practice address
824 JOHN MARSHALL HWY STE 203, FRONT ROYAL, VA 22630-3744
(540) 655-2936
(540) 736-4371
Mailing address
1100 BUSINESS PKWY S STE 1, WESTMINSTER, MD 21157-3048
(540) 655-2936
(540) 736-4371
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/07/2026
Last updated
01/30/2026
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