Organization
TYSONS MENTAL HEALTH CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MEHDI EBRAHIMI BOROUMAND (MEMBER/MANAGER)
(301) 377-4626
Entity
Organization
Contact information
Practice address
450 WEST BROAD STREET, SUITE 304, FALLS CHURCH, VA 22046-3318
(703) 270-5847
(703) 270-5848
Mailing address
450 WEST BROAD STREET, SUITE 304, FALLS CHURCH, VA 22046-3318
(703) 270-5847
(703) 270-5848
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
05/23/2018
Last updated
05/23/2018
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