Clementine Twin Lakes, LLC
Clementine Twin Lakes, LLC is an Adolescent and Children Mental Health Clinic/Center in Fairfax Station, Virginia. Registered with an NPI since 2021.
- In the registry since
- 2021
- Specialties on file
- 3
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
11329 Henderson RdFairfax Station, VA 22039-2314
Phone: (305) 663-1876
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Psychiatric Residential Treatment Facility (primary) | Taxonomy 323P00000X |
|---|---|
| Adolescent and Children Mental Health Clinic/Center | Taxonomy 261QM0855X |
| Mental Illness Community Based Residential Treatment Facility | Taxonomy 320800000X |
Record details
| NPI number | 1689269250 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Mike Bagley — Chief Financial Officer · (305) 663-1876 |
| Other names | Clementine Fairfax; Clementine Fairfax |
| NPI enumerated | March 5, 2021 |
| Last updated in NPPES | October 16, 2025 |
| Certification date | October 16, 2025 |
| Mailing address | 6100 Sw 76th St, South Miami, FL 33143-5002 |