1St Promise Residential Services, LLC

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

1ST PROMISE RESIDENTIAL SERVICES, LLC

Practice address

10127 Woodbury Dr Apt 512
Manassas, VA 20109-3781

Phone

(571) 278-1273

NPI assigned

Dec 10, 2021

Organization subpart

No

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

Authorized official

Name

Ferdinand Atabongawung

Title

Owner

Phone

(571) 278-1273

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1639094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639094400000",
    "number": "1376202051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10127 WOODBURY DR APT 512",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201093781",
            "telephone_number": "571-278-1273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10127 WOODBURY DR APT 512",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201093781",
            "telephone_number": "571-278-1273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1ST PROMISE RESIDENTIAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-10",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A",
        "authorized_official_last_name": "ATABONGAWUNG",
        "authorized_official_first_name": "FERDINAND",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "571-278-1273"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3979",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• 1 Ameliorate Healthcare Services LLC
• 1 On 1 at Home Care, LLC
• 24-7 Medical Transportation Service LLC
• A & F Transportation Services Inc
• A and a Non Emergency Medical Transportation LLC
• A Balanced Life RX LLC
• A Lean on Me, LLC

• All providers in Manassas, VA
• Developmentally Disabled Services Day Training Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2021; 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.