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PROVIDENT ARC LLC NPI 1285957761


NPI Information

NPI: 1285957761
Provider Name: PROVIDENT ARC LLC
Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
Entity Type: Organization
Address:
17300 RIVER RIDGE BLVD
SUITE 301
WOODBRIDGE, VA
ZIP 22191
Phone: (703) 861-4409
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PROVIDENT ARC LLC is a residential treatment facility, intellectual and/or developmental disabilities in Woodbridge, VA. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. PROVIDENT ARC LLC NPI is 1285957761. The provider is registered as an organization entity type.

The provider's business location address is:

17300 RIVER RIDGE BLVD
SUITE 301
WOODBRIDGE, VA
ZIP 22191-167
Phone: (703) 861-4409

The provider's authorized official is Reynaldo Roundtree .
The authorized official title is Co-owner and has the following contact phone number (703) 861-4409.

The enumeration date for this NPI number is 3/11/2010 and was last updated on 3/11/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1320600000XResidential Treatment Facility, Intellectual and/or Developmental Disabilities954VIRGINIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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