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Organization

COMPASSIONATE CARE GROUP HOMES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GEORGETTE DEYONOU (PROGRAM DIRECTOR)
(240) 604-4921
Entity
Organization

Contact information

Practice address
4413 SAN CARLOS DR, FAIRFAX, VA 22030-5372
(240) 604-4921
Mailing address
4413 SAN CARLOS DR, FAIRFAX, VA 22030-5372

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
2539-01-001
VA

Other

Enumeration date
07/07/2016
Last updated
07/07/2016
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