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General NPI Number Information
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NPI Number | 1124913421
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Entity Type | Organization
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Legal Business Name | ROCK CREEK HOMES LLC
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 64A SYCOLIN RD SE
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City | LEESBURG
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State | VA
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Zip | 20175-4105
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Country | US
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Telephone | 540-974-2090
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Fax |
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Provider Business Mailing Address
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Address Line | 4627 ASPEN HILL CT
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City | ANNANDALE
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State | VA
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Zip | 22003-3573
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Country | US
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Telephone | 703-839-2850
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Fax |
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Authorized Official
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Title or Position | EXEC
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Name | LILY DOBSON
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Credential |
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Telephone | 703-839-2850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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