Organization
PRISTINE HEALTHCARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RITA MENSAH DOMFEH (DIRECTOR)
(571) 723-3289
Entity
Organization
Contact information
Practice address
14402 NEWBERN LOOP, GAINESVILLE, VA 20155-1479
(571) 723-3289
Mailing address
14402 NEWBERN LOOP, GAINESVILLE, VA 20155-1479
(571) 723-3289
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/28/2019
Last updated
10/28/2019
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