Organization
ELITES CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AWONTI ETOO NDJONGO (CHIEF EXECUTIVE OFFICER)
(703) 660-9101
Entity
Organization
Contact information
Practice address
6911 RICHMOND HWY STE 302, ALEXANDRIA, VA 22306-1846
(703) 660-9101
Mailing address
6911 RICHMOND HWY STE 302, ALEXANDRIA, VA 22306-1846
(703) 660-9101
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/22/2021
Last updated
02/22/2021
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