MEDICARE: AAA RESIDENCIES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942928189
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AAA RESIDENCIES, INC.

Provider Business Mailing Address
First Line	:	6094 FRANCONIA RD STE A
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22310-4433
Country	:	US
Telephone Number	:	571-220-9499
Fax Number	:

Provider Business Practice Location Address
First Line	:	5814 TILBURY ROAD
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22310-2231
Country	:	US
Telephone Number	:	571-220-9499
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. PAWAN K GUPTA
Credential	:
Telephone Number	:	571-220-9499

Provider Enumeration Date	:	08/15/2022
Last Update Date	:	09/29/2022

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Directions to “AAA RESIDENCIES, INC. ” Practice Location

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