Jean Sylvain Ateba Ondoua
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Manassas Park, VA. Individual provider (NPI-1).
NPI number1760104863
StatusActive
Last updated in NPPESSep 15, 2022
Details
- NPI
- 1760104863
- Entity type
- Individual (NPI-1)
- Name
- Mr. Jean Sylvain Ateba Ondoua
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 15, 2022
- Certification date
- Sep 15, 2022
- Last updated
- Sep 15, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320600000X | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | 3567 | VA | Yes |
Practice location
9229 Matthew DrManassas Park, VA 20111-2451
Phone 240-423-4691 · Fax 443-773-1367
Mailing address
9229 Matthew DrManassas Park, VA 20111-2451
Phone 240-423-4691 · Fax 443-773-1367
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