Organization
COLLABORATIVE COMMUNITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMEL DENNARD KIMBRO (CEO)
(202) 355-4327
Entity
Organization
Contact information
Practice address
6000 FILBERT CT, SPRINGFIELD, VA 22152-1609
(202) 355-4327
Mailing address
6000 FILBERT CT, SPRINGFIELD, VA 22152-1609
(202) 355-4327
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/07/2020
Last updated
05/07/2020
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