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Organization
SCARLET HAVEN RESIDENTIAL SERVICES
Active
Organization
SCARLET HAVEN RESIDENTIAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EULA KHADIJATU SECKA (ADMINISTRATOR)
(240) 645-7642
Entity
Organization
Contact information
Practice address
1346 OLD BRIDGE RD, SUITE 100, WOODBRIDGE, VA 22192-2743
(240) 645-7642
(703) 890-3160
Mailing address
1346 OLD BRIDGE RD, SUITE 100, WOODBRIDGE, VA 22192-2743
(703) 490-1197
(703) 890-3160
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
2371-01-001
VA
251F00000X
Home Infusion Agency
2371-01-001
VA
251J00000X
Nursing Care Agency
2371-01-001
VA
251S00000X
Community/Behavioral Health Agency
2371-01-001
VA
253Z00000X
In Home Supportive Care Agency
2371-01-001
VA
314000000X
Skilled Nursing Facility
2371-01-001
VA
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
2371-01-001
VA
343900000X
Non-emergency Medical Transport (VAN)
2371-01-001
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2371
DBHDS
VA
01
—
2371-01-001
DBHDS
VA
Enumeration date
10/19/2015
Last updated
10/19/2015
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