Organization
OLIVE BRANCH BEHAVIOR THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAHARLA JAMA (DIRECT SUPPORT PROFESSIONAL)
(571) 800-7777
Entity
Organization
Contact information
Practice address
6399 LITTLE RIVER TPKE, ALEXANDRIA, VA 22312-5093
(571) 800-7777
Mailing address
3645 MADISON WATCH WAY, FALLS CHURCH, VA 22041-3681
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
10/03/2025
Last updated
10/03/2025
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