PROVENANCE SUBSTANCE ABUSE & WELLNESS CENTERS LLC
NPI 1649976945
Clinic/Center - Mental Health (Including Community Mental Health Center) in Glen Allen, VA

Q: What is Provenance Substance Abuse & Wellness Centers LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Active since February 07, 2023

4870 SADLER RD PMB #8903, SUITE 300, GLEN ALLEN, VA 23060(480) 442-9819 Get Directions Write a Review

NPPES record last updated: August 20, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 20, 2024, Aug 7, 2023, Feb 7, 2023 (3 updates tracked since 2023).

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About Provenance Substance Abuse & Wellness Centers Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVENANCE SUBSTANCE ABUSE & WELLNESS CENTERS LLC (NPI 1649976945) is a healthcare organization registered as a mental health (including community mental health center) in Glen Allen, Virginia and active in the NPI registry since February 2023. The organization lists Devolis Newburn, Owner, as its authorized official.

NPPES Registry Identity

NPI1649976945

Entity TypeOrganization

Primary Taxonomy261QM0801X

Legal Business NamePROVENANCE SUBSTANCE ABUSE & WELLNESS CENTERS LLC

Location Address4870 SADLER RD PMB #8903, SUITE 300Glen Allen, VA 23060

Mailing Address4870 Sadler Rd Pmb #8903, Suite 300Glen Allen, VA 23060

Phone(480) 442-9819

Organization SubpartNo

Authorized OfficialDevolis NewburnOwner · (480) 442-9819

Enumeration DateFebruary 7, 2023

Last NPPES UpdateAugust 20, 20243 updates tracked since enumeration

NPPES CertifiedAugust 20, 2024

✔ NPI 1649976945 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities

Taxonomy Code261QM0801X

Also ListedClinic/Center · Rehabilitation, Substance Use DisorderTaxonomy 261QR0405X

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Provenance Substance Abuse & Wellness Centers LLC's NPI number?

The NPI number for Provenance Substance Abuse & Wellness Centers LLC is 1649976945. It was assigned to this organization in the NPPES registry on February 7, 2023.

Where is Provenance Substance Abuse & Wellness Centers LLC located?

Provenance Substance Abuse & Wellness Centers LLC is located at 4870 Sadler Rd Pmb #8903 Suite 300, Glen Allen, VA 23060. The listed phone number is (480) 442-9819.

What is Provenance Substance Abuse & Wellness Centers LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

When was this NPI record last updated?

The NPPES record for Provenance Substance Abuse & Wellness Centers LLC was last updated on August 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.