Provider Demographics
NPI:1750908034
Name:VOLTAIRE BEHAVIORAL HEALTH AND WELLNESS, LLC
Entity type:Organization
Organization Name:VOLTAIRE BEHAVIORAL HEALTH AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARLAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:REGISTE
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:850-544-1414
Mailing Address - Street 1:6806 RUSKIN ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-2041
Mailing Address - Country:US
Mailing Address - Phone:850-544-1414
Mailing Address - Fax:773-373-0296
Practice Address - Street 1:1200 G ST NW STE 800
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-6705
Practice Address - Country:US
Practice Address - Phone:202-743-1955
Practice Address - Fax:773-373-0296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-02
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty