MEDICARE: NU DIMENSIONS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1578925806
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NU DIMENSIONS, LLC

Provider Business Mailing Address
First Line	:	3602 BALIN CT
Second Line	:
City	:	ANNANDALE
State	:	VA
Zip	:	22003-1301
Country	:	US
Telephone Number	:	703-479-8716
Fax Number	:

Provider Business Practice Location Address
First Line	:	3602 BALIN CT
Second Line	:
City	:	ANNANDALE
State	:	VA
Zip	:	22003
Country	:	US
Telephone Number	:	703-479-8716
Fax Number	:

Authorized Official
Title or Position	:	PROGRAM DIRECTOR
Name	:	SOLOMON NCHINDA
Credential	:
Telephone Number	:	908-463-3115

Provider Enumeration Date	:	03/25/2016
Last Update Date	:	03/25/2016

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