Provider Demographics
NPI:1164293114
Name:A-Z MENTAL HEALTH LLC
Entity Type:Organization
Organization Name:A-Z MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF DIRECTOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ODILE
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LA CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:HUMAN RESOURCES SPEC
Authorized Official - Phone:703-586-8434
Mailing Address - Street 1:31 ONTELL CT
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-1566
Mailing Address - Country:US
Mailing Address - Phone:703-586-8434
Mailing Address - Fax:888-315-4281
Practice Address - Street 1:7530 DIPLOMAT DR STE 101
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-2682
Practice Address - Country:US
Practice Address - Phone:703-586-8434
Practice Address - Fax:888-315-4281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)