Organization
ALTERNATIVE LIVING RESIDENCES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYDIA TITY JANNAH (OWNER)
(571) 477-8097
Entity
Organization
Contact information
Practice address
4 FLEWELLEN DR, STAFFORD, VA 22554-7829
(571) 477-8097
Mailing address
14090 BIG CREST LN, WOODBRIDGE, VA 22191-5530
(571) 477-8097
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
04/15/2024
Last updated
04/15/2024
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