Organization
WISDOM ONE LLC
Active
Other names
WISDOM ONE LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES TEKEH (CEO)
(571) 642-5258
Entity
Organization
Contact information
Practice address
7420 ALBAN STATION BLVD STE B226, SPRINGFIELD, VA 22150-2325
(571) 642-5258
Mailing address
7420 ALBAN STATION BLVD STE B226, SPRINGFIELD, VA 22150-2325
(571) 642-5258
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
251G00000X
Community Based Hospice Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
310400000X
Assisted Living Facility
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
372600000X
Adult Companion
—
—
385H00000X
Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
09/27/2021
Last updated
09/27/2021
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