Organization
CAMELLIA LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLINA KHAN (CEO)
(571) 442-4053
Entity
Organization
Contact information
Practice address
1124 MADEIRA TER SE, LEESBURG, VA 20175-4789
(571) 442-4053
Mailing address
1124 MADEIRA TER SE, LEESBURG, VA 20175-4789
(571) 442-4053
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
Other
Enumeration date
08/09/2023
Last updated
08/09/2023
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