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General NPI Number Information
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NPI Number | 1518884675
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Entity Type | Organization
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Legal Business Name | ABETHA COMMUNITY SERVICES
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Dates
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Enumeration Date | 06/30/2026
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Last Update Date | 06/30/2026
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Provider Practice Location Address
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Address Line | 14526 FULLERTON RD
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City | WOODBRIDGE
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State | VA
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Zip | 22193-2035
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Country | US
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Telephone | 240-755-7503
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Fax |
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Provider Business Mailing Address
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Address Line | 14104 ABERDEENS FOLLY CT
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City | BOWIE
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State | MD
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Zip | 20720-5804
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | OUSMANE BALDE
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Credential |
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Telephone | 240-755-7503
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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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