Organization
ANNA & RAPHAEL RESIDENTIAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BIBIIANA EZEONYIM (ADMINISTRATOR)
(240) 426-0447
Entity
Organization
Contact information
Practice address
13705 MAPLEDALE AVE, WOODBRIDGE, VA 22193-4455
(571) 209-0013
Mailing address
6 PIDGEON HILL DR STE 240, STERLING, VA 20165-6176
(571) 209-0013
(571) 313-0196
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
07/21/2023
Last updated
07/21/2023
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