Provider Demographics
NPI:1407508161
Name:BRE ENTERPRISES, LLC
Entity Type:Organization
Organization Name:BRE ENTERPRISES, LLC
Other - Org Name:THE WILLIAMS CENTER FOR WELLNESS AND RECOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RODERICK
Authorized Official - Middle Name:LAMAR
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-795-8793
Mailing Address - Street 1:2 CARDINAL PARK DR SE STE 103A
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-4448
Mailing Address - Country:US
Mailing Address - Phone:703-795-8793
Mailing Address - Fax:
Practice Address - Street 1:2 CARDINAL PARK DR SE STE 103A
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-4448
Practice Address - Country:US
Practice Address - Phone:703-795-8793
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRE ENTERPRISES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-24
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health