Organization
MEDTECHCARESYSTEMS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN DICK NDIKUM (CEO)
(240) 603-8579
Entity
Organization
Contact information
Practice address
3200 HOLLY BERRY CT, FALLS CHURCH, VA 22042-3315
(703) 846-0312
Mailing address
3200 HOLLY BERRY CT, FALLS CHURCH, VA 22042-3315
(703) 846-0312
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
320600000
VA
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
VA
Other
Enumeration date
07/23/2015
Last updated
07/23/2015
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