Organization
JAKAFI BEHAVIORAL CARE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KWADWO O ANYANE-NTOW (CO-OWNER)
(919) 491-2436
Entity
Organization
Contact information
Practice address
107 MAIFIELD AVE, WAVERLY, VA 23890-5000
(804) 834-2303
Mailing address
PO BOX 1464, DURHAM, NC 27702-1464
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
VA
251S00000X
Community/Behavioral Health Agency
Primary
—
VA
Other
Enumeration date
03/05/2015
Last updated
03/05/2015
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