Provider Demographics
NPI:1275315160
Name:MAJOR ADDICTION AND RECOVERY HOUSE LLC
Entity Type:Organization
Organization Name:MAJOR ADDICTION AND RECOVERY HOUSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIANI
Authorized Official - Middle Name:
Authorized Official - Last Name:MAJOR
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:804-898-8794
Mailing Address - Street 1:2807 N PARHAM RD STE 320
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4410
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2807 N PARHAM RD STE 320
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23294-4410
Practice Address - Country:US
Practice Address - Phone:804-898-8794
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility