# SKY RESIDIENTIAL CARE SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164240636
- **Authorized official:** MR. PRIMUS ALUNGAMOH NKEMBETANG (ADMIN)
- **Authorized official phone:** (571) 315-5698

## Contact information

- **Practice address:** 9089 CONNOR HOUSE RD, MANASSAS, VA 20110-1766
- **Practice address phone:** (571) 315-5698
- **Mailing address:** 9089 CONNOR HOUSE RD, MANASSAS, VA 20110-1766
- **Mailing address phone:** (571) 315-5698

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 10/02/2024
- **Last updated:** 10/02/2024