Potter'S Group Home LLC

Primary specialty

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

Legal business name

POTTER'S GROUP HOME LLC

Practice address

3641 Dahlgren Place
Dumfries, VA 22026-2602

Phone

(571) 477-8172

Fax

(703) 221-9746

NPI assigned

Aug 28, 2023

Organization subpart

No

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

Authorized official

Name

ABA AduseiNPI 1528751484

Title

Ceo/Program Director

Phone

(571) 477-8172

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• ABA Adusei

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Dumfries, VA
  • NPI 1528751484

  Community Based Residential Treatment Facility, Intellectual and/Or Developmental Disabilities

  NPD Authorized official

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693180800000",
    "number": "1346025368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3641 DAHLGREN PLACE",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "220262602",
            "telephone_number": "571-477-8172",
            "fax_number": "703-221-9746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3641 DAHLGREN PLACE",
            "city": "DUMFRIES",
            "state": "VA",
            "postal_code": "220262602",
            "telephone_number": "571-477-8172",
            "fax_number": "703-221-9746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTTER'S GROUP HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A",
        "authorized_official_last_name": "ADUSEI",
        "authorized_official_first_name": "ABA",
        "authorized_official_title_or_position": "CEO/PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "571-477-8172"
    },
    "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": []
}

• Traci Perkins, RBT
• Petros Assefa Ayele
• Play to Say Therapy LLC
• Breanna Pollard, RBT
• Alana Popa
• Shemikamarie Cooper Powell
• Powerhouse Chapel International
• Lisa Pralle, RN
• Edward B Price, M.P.T.
• Rhiannon Price, LCSW

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Dumfries, VA
• Providers in Dumfries, 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 Aug 28, 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.