Home Away Residential Services LLC
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Woodbridge, VA. Organization (NPI-2).
Details
- NPI
- 1164076790
- Entity type
- Organization (NPI-2)
- Legal business name
- Home Away Residential Services LLC
- Organization subpart
- No
- Enumeration date
- Jul 31, 2019
- Last updated
- Jul 31, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | – | – | Yes |
Other names
- Home Away Residential Services LLC (Former Legal Business Name)
Practice location
4304 Eldorado DrWoodbridge, VA 22193-2716
Phone 301-807-6184 · Fax 301-464-0225
Mailing address
4304 Eldorado DrWoodbridge, VA 22193-2716
Phone 301-807-6184 · Fax 301-464-0225
Authorized official
Nkenglefe Felix Atangcho
Owner
3018076184
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