# REVERENCE AND RESILIENCE DIRECT CARE SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Reverenceand Resilience Direct Care Service
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639333123
- **Authorized official:** MR. MICHAEL OPOKU AGYEMAN (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (703) 386-6392

## Contact information

- **Practice address:** 15277 FOREST GROVE DR, WOODBRIDGE, VA 22191-3911
- **Practice address phone:** (703) 349-0963
- **Practice address fax:** (703) 441-1789
- **Mailing address:** 15277 FOREST GROVE DR, WOODBRIDGE, VA 22191-3911
- **Mailing address phone:** (703) 349-0963
- **Mailing address fax:** (703) 441-1789

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 07/14/2008
- **Last updated:** 07/14/2008