Organization
NILE SUPPORTIVE LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELISABETH TESHOME (OWNER)
(703) 966-3527
Entity
Organization
Contact information
Practice address
14640 ESTATE DR, WOODBRIDGE, VA 22193-3225
(703) 966-3527
Mailing address
14640 ESTATE DR, WOODBRIDGE, VA 22193-3225
(703) 966-3527
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
02/22/2025
Last updated
02/22/2025
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