Organization · NPI-2

Alternative Living Residences LLC

In Home Supportive Care · Stafford, VA

NPI number1689428849
StatusActive
Last updated in NPPESApr 15, 2024

Details

NPI
1689428849
Entity type
Organization (NPI-2)
Legal business name
Alternative Living Residences LLC
Organization subpart
No
Enumeration date
Apr 15, 2024
Certification date
Apr 15, 2024
Last updated
Apr 15, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
253Z00000X In Home Supportive Care––Yes

Practice location

4 Flewellen Dr
Stafford, VA 22554-7829

Phone 571-477-8097

Mailing address

14090 Big Crest Ln
Woodbridge, VA 22191-5530

Phone 571-477-8097

Authorized official

Lydia Tity Jannah
Owner
5714778097

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