Salvation Academy

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

SALVATION ACADEMY

Practice address

4810 Beauregard St
Suite G1-4
Alexandria, VA 22312-1709

Phone

(571) 405-6465

NPI assigned

Oct 5, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Brima Bob Deen, BA.,ADBS., GBM.

Title

President

Phone

(571) 217-8394

Specialties & licenses 1

Addresses

Other names 1

• SALVATION ACADEMY Former legal business name

Tax ID family

Salvation Academy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Salvation Academy

  dba Salvation Academy Medical Staffing

  • Home Health Aide
  • Alexandria, VA
  • NPI 1457645160
  NPD tax ID

Locations

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

{
    "created_epoch": "1254700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254700800000",
    "number": "1316272628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4810 BEAUREGARD ST",
            "address_2": "SUITE G1-4",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223121709",
            "telephone_number": "571-405-6465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4810 BEAUREGARD ST",
            "address_2": "SUITE G1-4",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223121709",
            "telephone_number": "571-405-6465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALVATION ACADEMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-05",
        "last_updated": "2009-10-05",
        "status": "A",
        "authorized_official_last_name": "DEEN",
        "authorized_official_first_name": "BRIMA",
        "authorized_official_middle_name": "BOB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "571-217-8394",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BA.,ADBS., GBM."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SALVATION ACADEMY",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Leah Sallada
• Muhannad Rafed Salman, RRT
• Gonzalo Mauro Salomon Barreda, CRNA
• Salus Vita
• Keya Salvary
• Salvation Academy (Salvation Academy Medical Staffing)
• Salvation Academy Health Care & Security Services LLC (Salvation Academy Home Health Agency)
• Tamba Sam-Manimoi
• Albert D Sam II, MD
• Sam's Neurology, LLC

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2009; 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.