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General NPI Number Information
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NPI Number | 1922551415
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Entity Type | Organization
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Legal Business Name | MEETOWN RESIDENTIAL CARE INC
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Dates
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Enumeration Date | 08/01/2016
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Last Update Date | 08/01/2016
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Provider Practice Location Address
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Address Line | 6601 LITTLE RIVER TPKE SUITE 210
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City | ALEXANDRIA
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State | VA
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Zip | 22312-1303
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Country | US
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Telephone | 703-884-5505
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Fax |
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Provider Business Mailing Address
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Address Line | 6601 LITTLE RIVER TPKE SUITE 210
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City | ALEXANDRIA
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State | VA
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Zip | 22312-1303
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Country | US
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Telephone | 703-884-5505
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF SERVICES
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Name | MARIATU CONTEH
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Credential |
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Telephone | 703-884-5505
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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 | 2241
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 2241
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number | 2241
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License Number State | VA
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Taxonomy #4
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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 | 2241
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License Number State | VA
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