Bethel Residential Services LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

BETHEL RESIDENTIAL SERVICES LLC

Practice address

1966 Powells Landing Cir
Woodbridge, VA 22191-4440

Phone

(703) 371-9909

NPI assigned

Aug 5, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kenneth Acheampong

Title

Director

Phone

(703) 371-9909

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1564963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564963200000",
    "number": "1144875337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1966 POWELLS LANDING CIR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221914440",
            "telephone_number": "703-371-9909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1966 POWELLS LANDING CIR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221914440",
            "telephone_number": "703-371-9909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETHEL RESIDENTIAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-05",
        "last_updated": "2019-08-05",
        "status": "A",
        "authorized_official_last_name": "ACHEAMPONG",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "703-371-9909"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Woodbridge, VA
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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.