Organization
HANDS OF MERCY GROUP HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FADUMA HUSSEIN (CEO)
(571) 338-2684
Entity
Organization
Contact information
Practice address
12783 CRUZ CT, FAIRFAX, VA 22030-7283
(703) 635-3306
(703) 830-3699
Mailing address
10560 MAIN ST STE 406, FAIRFAX, VA 22030-7174
(703) 635-3306
(703) 830-3699
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/06/2019
Last updated
11/12/2019
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