Organization
MUDITA LIVING LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VANDANA PONNALA (DIRECTOR)
(571) 449-0853
Entity
Organization
Contact information
Practice address
1202 E HOLLY AVE, STERLING, VA 20164-2612
(571) 449-0853
Mailing address
23699 HEATHER MEWS DR, ASHBURN, VA 20148-1812
(571) 449-0853
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
10/07/2022
Last updated
10/07/2022
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