ABSOLUTE MENTAL HEALTH CLINIC LLC


Address: 1303 Florida Ave, Woodbridge, VA 22191-3620
Phone: 5713982758

ABSOLUTE MENTAL HEALTH CLINIC LLC (NPI# 1366007460) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1366007460
Entity Type Organization
Organization Name ABSOLUTE MENTAL HEALTH CLINIC LLC
Practice Address 1303 Florida Ave
Woodbridge
VA 22191-3620
Practice Telephone 5713982758
Mailing Telephone 5713982758
Enumeration Date 2019-05-03
Last Update Date 2019-05-03
Authorized Official Name MAXIMO DE LA CRUZ (CHIEF DIRECTOR)
Authorized Official Telephone 5715720050
Authorized Official Credential QMHP-C-MA
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM0855X Clinic/Center
Specialization: Adolescent and Children Mental Health
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
VA CERTIFICATE OF ASSUMED OR FICTITIOUS NAME 201509030074274 01

Office Location

Street Address 1303 FLORIDA AVE
City WOODBRIDGE
State VA
Zip Code 22191-3620

Providers in the same location

NPI Name Taxonomy Address Enumeration
1043875248 Maximo De La Cruz Clinic/Center 1303 Florida Ave, Woodbridge, VA 22191-3620 2019-05-03

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1861021131 Bailey Orthodontics Pllc Dentist 16446 Navigation Drive, Woodbridge, VA 22191 2020-04-07
1417589326 Meseret Abate Registered Nurse 15608 William Bayliss Ct, Woodbridge, VA 22191 2020-02-08
1992279327 Velocity Urgent Care, LLC Clinic/Center 16422 Navigation Dr, Woodbridge, VA 22191 2019-01-18
1821577263 Maame Gyasiwah Banahene Registered Nurse 1812 Featherstone Rd, Woodbridge, VA 22191 2018-08-07
1235617507 Yaw P. Baidoo Nutritionist 14960 Potomac Heights Pl Apt 503, Woodbridge, VA 22191 2018-07-30
1477048452 Anahita Abazari Optometrist 14901 Potomac Town Pl, Suite 120, Woodbridge, VA 22191 2018-06-22
1619490661 Misti S Gray Nurse Practitioner 2296 Optiz Blvd, Suite 440, About Women Ob/gyn, Woodbridge, VA 22191 2017-07-21
1568991974 Patrice Whilby Behavior Technician 2264 York Drive Apt 302, Woodbridge, VA 22191 2017-06-08
1508395245 Maria Theresa Lee Registered Nurse 2028b Opitz Blvd # 22191, Woodbridge, VA 22191 2017-06-07
1861943763 A1 Home Care, LLC Home Health 13928 Jefferson Davis Hwy, Ste # C, Woodbridge, VA 22191 2016-10-17
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Taxonomy Information

Taxonomy Code 261QM0855X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Adolescent and Children Mental Health

Taxonomy Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1740691443 Total Family Solutions, LLC Clinic/Center 1 Woodbridge Ctr Ste 440, Woodbridge, NJ 07095-1171 2014-05-15
1215260492 G&g Respite Services Clinic/Center 2810 Burrough Hill Ln, Woodbridge, VA 22191-5155 2009-09-06
1043875248 Maximo De La Cruz Clinic/Center 1303 Florida Ave, Woodbridge, VA 22191-3620 2019-05-03

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1194325191 Second Chance, LLC Clinic/Center 315 Hospital Dr Ste 105, Martinsville, VA 24112-1927 2020-10-28
1407454515 Always Blossom, LLC Clinic/Center 611 W Graham Rd, Richmond, VA 23222-4207 2020-10-12
1225645377 Crescent Moon Counseling LLC Clinic/Center 8016 Burrundie Dr, Richmond, VA 23225-1972 2020-09-23
1811512007 Schwarz Counseling and Coaching Clinic/Center 8109 Mechanicsville Turnpike, Suite 1c, Mechanicsville, VA 23111 2020-06-12
1174146708 Nova Telemental Health Clinic/Center 14012 Willet Way, Gainesville, VA 20155-5915 2020-05-18
1659993731 Sandstone Care Virginia, LLC Clinic/Center 11415 Isaac Newton Sq S, Reston, VA 20190-5005 2020-05-12
1306467147 Shenandoah Creative Counseling for Children and Adolescents Clinic/Center 510 W Broad St Ste H, Waynesboro, VA 22980-4548 2020-05-04
1801449855 Amazing Counseling LLC Clinic/Center 2428 Windy Pines Bnd, Virginia Beach, VA 23456-3954 2019-07-18
1912468190 Village Therapeutic Mentoring Services LLC Clinic/Center 1 W Cary St, Richmond, VA 23220-5609 2019-03-28
1801375118 Clementine Twin Lakes, LLC Clinic/Center 13215 Twin Lakes Dr, Clifton, VA 20124-1215 2018-08-08
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Competitor

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City WOODBRIDGE
Zip Code 22191

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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