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COLLABORATIVE COMMUNITY LLC NPI 1659993079


NPI Information

NPI: 1659993079
Provider Name: COLLABORATIVE COMMUNITY LLC
Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
6000 FILBERT CT
SPRINGFIELD, VA
ZIP 22152
Phone: (202) 355-4327
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COLLABORATIVE COMMUNITY LLC is a community based residential treatment facility, intellectual and/or developmental disabilities in Springfield, VA. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. COLLABORATIVE COMMUNITY LLC NPI is 1659993079. The provider is registered as an organization entity type.

The provider's business location address is:

6000 FILBERT CT
SPRINGFIELD, VA
ZIP 22152-609
Phone: (202) 355-4327

The provider's authorized official is Jamel Dennard Kimbro .
The authorized official title is Ceo and has the following contact phone number (202) 355-4327.

The enumeration date for this NPI number is 5/7/2020 and was last updated on 5/7/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.