Organization
HOME AWAY RESIDENTIAL SERVICES LLC
Active
Other names
Home away Residential services LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NKENGLEFE FELIX ATANGCHO (OWNER)
(301) 807-6184
Entity
Organization
Contact information
Practice address
4304 ELDORADO DR, WOODBRIDGE, VA 22193-2716
(301) 807-6184
(301) 464-0225
Mailing address
4304 ELDORADO DR, WOODBRIDGE, VA 22193-2716
(301) 807-6184
(301) 464-0225
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/31/2019
Last updated
07/31/2019
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