# NU-START YOUTH INTERVENTION SERVICES LLC

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

## Provider details

- **NPI number:** 1851673230
- **Authorized official:** MISS DONNETTE SHAW-CUNNINGHAM (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (202) 421-4130

## Contact information

- **Practice address:** 5039 BACKLICK RD, SUITE A, ANNANDALE, VA 22003-6046
- **Practice address phone:** (703) 750-1132
- **Practice address fax:** (703) 750-1142
- **Mailing address:** 5039 BACKLICK RD, SUITE A, ANNANDALE, VA 22003-6046
- **Mailing address phone:** (703) 750-1132
- **Mailing address fax:** (703) 750-1142

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | VA | Yes |

## Other

- **Enumeration date:** 09/13/2011
- **Last updated:** 12/27/2011