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Organization

BOX ELDER BEHAVIORAL HEALTH LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MARTHA MAURNO M.S. (OWNER, BUSINESS MANAGER)
(757) 274-7527
Entity
Organization

Contact information

Practice address
254 RAINBOW RIDGE, BUMPASS, VA 23024-4856
(757) 274-7527
Mailing address
254 RAINBOW RIDGE, BUMPASS, VA 23024-4856
(757) 274-7527
(757) 530-5196

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
251S00000X
Community/Behavioral Health Agency
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
0701004212
VA

Other

Enumeration date
09/02/2018
Last updated
05/20/2026
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