Organization
NOVARA RECOVERY CENTER VIRGINIA DRUG & ALCOHOL REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYLAN GROSH (MEMBER)
(703) 297-9909
Entity
Organization
Contact information
Practice address
2815 OLD LEE HWY FL 2, FAIRFAX, VA 22031-4303
(703) 705-7870
(862) 209-2213
Mailing address
2815 OLD LEE HWY FL 2, FAIRFAX, VA 22031-4303
(703) 705-7870
(862) 209-2213
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12453
COMMONWEALTH OF VIRGINIA
VA
Enumeration date
09/26/2024
Last updated
03/20/2025
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