Organization
COMMONWEALTH BEHAVIORAL ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BEN FITZGERALD (CEO)
(757) 634-7550
Entity
Organization
Contact information
Practice address
12828 WILLOW CENTRE DR STE D26, HOUSTON, TX 77066-3043
(757) 634-7550
Mailing address
6705 CASTLEWOOD CIR, SUFFOLK, VA 23435-3016
(757) 634-7550
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
10/17/2023
Last updated
10/24/2023
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