1ST PROMISE RESIDENTIAL SERVICES LLC NPI 1376202051

NPI Information

  • NPI: 1376202051
  • Provider Name: 1ST PROMISE RESIDENTIAL SERVICES, LLC
  • Classification: Day Training, Developmentally Disabled Services - 251C00000X
  • Entity Type: Organization
  • Address: 10127 WOODBURY DR APT 512
    MANASSAS, VA
    ZIP 20109
  • Phone: (571) 278-1273

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NPI Details

1ST PROMISE RESIDENTIAL SERVICES, LLC is a day training developmentally disabled services in Manassas, VA. The provider is these agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. 1ST PROMISE RESIDENTIAL SERVICES, LLC NPI is 1376202051. The provider is registered as an organization entity type.

The provider's business location address is:

10127 WOODBURY DR APT 512
MANASSAS, VA
ZIP 20109-781
Phone: (571) 278-1273

The provider's authorized official is Ferdinand Atabongawung .
The authorized official title is Owner and has the following contact phone number (571) 278-1273.

The enumeration date for this NPI number is 12/10/2021 and was last updated on 12/10/2021.

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
1251C00000XDay Training, Developmentally Disabled ServicesYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
13979MEDICAIDVIRGINIA

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: 11/21/2025

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