Organization
COMPASSIONATE HOMES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SYDONIE BONGAM DNP,PMHNP (DIRECTOR)
(301) 537-8248
Entity
Organization
Contact information
Practice address
3640 ELDERBERRY PL, FAIRFAX, VA 22033-1214
(301) 537-8248
Mailing address
15962 PAYNES FARM DR, HAYMARKET, VA 20169-8189
(301) 537-8248
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
08/24/2023
Last updated
04/19/2024
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