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General NPI Number Information
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NPI Number | 1396359576
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Entity Type | Organization
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Legal Business Name | BEST HOPE COMMUNITY RESIDENTIAL SERVICES
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Dates
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Enumeration Date | 09/03/2020
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Last Update Date | 09/03/2020
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Provider Practice Location Address
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Address Line | 9662 HAWKSHEAD DR
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City | LORTON
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State | VA
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Zip | 22079-2786
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Country | US
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Telephone | 571-931-0059
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Fax |
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Provider Business Mailing Address
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Address Line | 17571 GRAHAM ST
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City | DUMFRIES
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State | VA
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Zip | 22026-2342
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Country | US
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Telephone | 571-931-0059
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Fax | 703-763-2876
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Authorized Official
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Title or Position | CEO
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Name | GINNEFINE KANU
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Credential |
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Telephone | 571-931-0059
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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