Organization
MEDICAL MANAGEMENT OF VA LLC
Active
Parent organization
BRIDGING THE GAPS
Other names
HORIZONS OF HOPE
Organization subpart
Yes
Provider details
NPI number
Legal business name
BRIDGING THE GAPS
Authorized official
MR. PETER EWENS (CEO)
(954) 587-7771
Entity
Organization
Contact information
Practice address
10640 MAIN ST, SUITE 300, FAIRFAX, VA 22030-3821
(954) 587-7771
(954) 208-5770
Mailing address
11230 WAPLES MILL RD, SUITE 125, FAIRFAX, VA 22030-6087
(954) 587-7771
(954) 208-5770
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
42902001
VA
Other
Enumeration date
01/20/2010
Last updated
01/20/2010
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