Healthcare Provider Details
I. General information
NPI: 1114852100
Provider Name (Legal Business Name): EARTHORA ORCHARD LIVING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15117 MONTANUS DR
CULPEPER VA
22701-1676
US
IV. Provider business mailing address
15117 MONTANUS DR
CULPEPER VA
22701-1676
US
V. Phone/Fax
- Phone: 571-477-6137
- Fax:
- Phone: 571-477-6137
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251C00000X |
| Taxonomy | Developmentally Disabled Services Day Training Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MATILDA
ACHEAMPOMA
BARFI
Title or Position: OWNER
Credential: MHP
Phone: 571-477-6137