Healthcare Provider Details

I. General information

NPI: 1770446478
Provider Name (Legal Business Name): ANOINTED HOMES RESIDENTIAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3326 TONY CT
DUMFRIES VA
22026-2187
US

IV. Provider business mailing address

3326 TONY CT
DUMFRIES VA
22026-2187
US

V. Phone/Fax

Practice location:
  • Phone: 571-477-4673
  • Fax: 703-439-2412
Mailing address:
  • Phone: 571-477-4673
  • Fax: 703-439-2412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: ISATU KEBE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 571-477-4673