Organization
NU-START YOUTH INTERVENTION SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS DONNETTE SHAW-CUNNINGHAM (EXECUTIVE DIRECTOR)
(202) 421-4130
Entity
Organization
Contact information
Practice address
5039 BACKLICK RD, SUITE A, ANNANDALE, VA 22003-6046
(703) 750-1132
(703) 750-1142
Mailing address
5039 BACKLICK RD, SUITE A, ANNANDALE, VA 22003-6046
(703) 750-1132
(703) 750-1142
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
VA
Other
Enumeration date
09/13/2011
Last updated
12/27/2011
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