Aquila Recovery of Virginia LLC

NPI #1396388930 in Herndon, Virginia

Provider Information

NPI Number: 1396388930
Entity Type: Organization
Organization Name: Aquila Recovery of Virginia LLC
Primary Specialty: Counselor - Addiction (Substance Use Disorder)
Enumeration Date: Oct 28, 2019
Last Updated: Oct 28, 2019

Practice Location

Address: 425 CARLISLE DR STE B
City: Herndon
State: Virginia
ZIP Code: 20170-5618
Phone: (703) 464-5122

Authorized Official

Name: MR. ROBERT R COFFEY
Title: OWNER
Phone: (703) 464-5122

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X	Primary

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