Organization
RESTORE MENTAL HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
UCHECHI ANYALEBECHI (NURSE PRACTITIONER)
(571) 358-8692
Entity
Organization
Contact information
Practice address
4000 LEGATO RD STE 1100, FAIRFAX, VA 22033-2893
(571) 358-8692
Mailing address
4000 LEGATO RD STE 1100, FAIRFAX, VA 22033-2893
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15013327
—
VA
Enumeration date
10/19/2022
Last updated
10/19/2022
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