Organization
ACCESS CARE GROUP HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MA. ROSE DECENA LPN (PRESIDENT)
(571) 275-4329
Entity
Organization
Contact information
Practice address
914 W REDWOOD RD, STERLING, VA 20164-5117
(571) 275-4329
Mailing address
910 W REDWOOD RD, STERLING, VA 20164-5117
(571) 275-4329
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
01/11/2024
Last updated
01/11/2024
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