Providing Equal Opportunity Progressive Living Environments, Llc in Fredericksburg - Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities
Providing Equal Opportunity Progressive Living Environments, Llc - NPI 1174782304
Providing Equal Opportunity Progressive Living Environments, Llc is a Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities in Fredericksburg, Virginia. Providing Equal Opportunity Progressive Living Environments, Llc practices all healthcare services and medical treatments related to Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The NPI Number for Providing Equal Opportunity Progressive Living Environments, Llc is 1174782304. The last update date is 2008-06-03.
Providing Equal Opportunity Progressive Living Environments, Llc's current location address is 10301 Kupperton Ct, Fredericksburg, Virginia. You can contact this provider via phone number 5403738096. The mailing address for Providing Equal Opportunity Progressive Living Environments, Llc is 10301 Kupperton Ct, Fredericksburg, Virginia. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Providing Equal Opportunity Progressive Living Environments, Llc |
|---|---|
| Address | 10301 Kupperton Ct, Fredericksburg, Virginia |
| Phone Number | 5403738096 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER/DIRE |
|---|---|
| Authorized Official Name | Dameron Justin |
| Telephone Number | 5403738096 |
NPI Number Detail
| NPI Number | 1174782304 |
|---|---|
| Provider Enumeration Date | 2008-06-03 |
| Last Updated Date | 2008-06-03 |
Provider Mailing Address Detail
| Address | 10301 Kupperton Ct |
|---|---|
| City | Fredericksburg |
| State | Virginia (VA) |
| Post Code | 224088054 |
| Phone Number | 5403738096 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
|---|---|
| Taxonomy | 320900000X |
| Licence No | 112501001 |
|
Definition: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 112501001 | VA | DEPARTMENT OF MENTAL HEALTH ME |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Providing Equal Opportunity Progressive Living Environments, Llc by the Centers for Medicare & Medicaid Services?
The Providing Equal Opportunity Progressive Living Environments, Llc has been issued the NPI (National Provider Identifier) 1174782304, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Providing Equal Opportunity Progressive Living Environments, Llc is physically located?
The Providing Equal Opportunity Progressive Living Environments, Llc is situated at the following address: 10301 Kupperton Ct, Fredericksburg, VA 224088054.
What is the area of specialization for Providing Equal Opportunity Progressive Living Environments, Llc, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Providing Equal Opportunity Progressive Living Environments, Llc is Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities, and the corresponding taxonomy code that categorizes this area of expertise is 320900000X.
When was the Providing Equal Opportunity Progressive Living Environments, Llc's 1174782304 issued?
The Providing Equal Opportunity Progressive Living Environments, Llc's 1174782304 was issued on 2008-06-03.
When was the Providing Equal Opportunity Progressive Living Environments, Llc's information last updated?
The Providing Equal Opportunity Progressive Living Environments, Llc's information was last updated on 2008-06-03.
NPI Number: 1023011681
Address: 506 Cromwell Ave, Rocky Hill, CT