Organization
EXCELLENT CARE RESIDENTIAL SERVICES LLC
Active
Other names
EXCELLENT CARE RESIDENTIAL SERVICES LLC
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA NKUROKO AMBE (DIRECTOR)
(571) 201-5841
Entity
Organization
Contact information
Practice address
6400 RIVINGTON RD, SPRINGFIELD, VA 22152-2912
(571) 201-5841
Mailing address
6400 RIVINGTON RD, SPRINGFIELD, VA 22152-2912
(571) 201-5841
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/08/2020
Last updated
11/08/2021
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