Provider Demographics
NPI:1831951540
Name:ADVANCED BEHAVIORAL CENTER LLC
Entity type:Organization
Organization Name:ADVANCED BEHAVIORAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-920-2911
Mailing Address - Street 1:13510 E BOUNDARY RD STE 104
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-4057
Mailing Address - Country:US
Mailing Address - Phone:804-920-2911
Mailing Address - Fax:804-773-4366
Practice Address - Street 1:13510 E BOUNDARY RD STE 104
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-4057
Practice Address - Country:US
Practice Address - Phone:804-920-2911
Practice Address - Fax:804-773-4366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health