Bennett Group Home LLC

Primary specialty

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

Legal business name

BENNETT GROUP HOME LLC

Doing business as

Bennett Group Home LLC

Practice address

16020 Crossed Talons Rd
Woodbridge, VA 22193-5797

Phone

(703) 597-6529

NPI assigned

May 9, 2023

Last updated

May 9, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Abena Fynn Swatson, BS, MBA, PHD

Title

Administrator

Phone

(703) 597-6529

Specialties & licenses 1

Addresses

Other names 1

• Bennett Group Home LLC Doing business as

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

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683590400000",
    "number": "1144910746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16020 CROSSED TALONS RD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221935797",
            "telephone_number": "703-597-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16020 CROSSED TALONS RD",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221935797",
            "telephone_number": "703-597-6529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENNETT GROUP HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-09",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A",
        "authorized_official_last_name": "FYNN SWATSON",
        "authorized_official_first_name": "ABENA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "703-597-6529",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "BS, MBA, PHD"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bennett Group Home LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aida Bengussie, LCSW
• Annetta Serena Benjamin, LPC
• Christine Marie Benjamin, DSP
• Powum Bennam, PHARMD
• Ehab Bennasir
• Bennett Home Care Agency
• Danielle Renee Benninghoff
• N'Dea Bryauna Benson
• Kambeez Berenji, MD
• Benjamin F Berger, B.S.

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• 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 May 9, 2023; 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.