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General NPI Number Information
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NPI Number | 1750652764
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Entity Type | Organization
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Legal Business Name | ALTERNATIVE HOUSE - THE ABUSED AND HOMELESS CHILDREN'S REFUGE
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Dates
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Enumeration Date | 01/23/2012
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Last Update Date | 01/23/2012
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Provider Practice Location Address
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Address Line | 2100 GALLOWS RD
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City | VIENNA
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State | VA
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Zip | 22182-3910
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Country | US
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Telephone | 703-506-9191
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Fax | 703-506-8949
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Provider Business Mailing Address
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Address Line | PO BOX 694
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City | DUNN LORING
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State | VA
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Zip | 22027-0694
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Country | US
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Telephone | 703-506-9191
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Fax | 703-506-8949
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. JUDITH DITTMAN
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Credential |
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Telephone | 703-506-9191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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