Didlake, Inc.

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

12002006 Issued in VA

Legal business name

DIDLAKE, INC.

Practice address

8621 Breeden Ave
Manassas, VA 20110-8413

Phone

(703) 361-4195

Fax

(703) 369-2719

NPI assigned

Mar 14, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Donna J Hollis

Title

Chief Financial Officer

Phone

(703) 361-4195

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487623492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8641 BREEDEN AVE",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201108431",
            "telephone_number": "703-361-4195",
            "fax_number": "703-369-2719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8621 BREEDEN AVE",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201108413",
            "telephone_number": "703-361-4195",
            "fax_number": "703-369-2719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIDLAKE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLLIS",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "703-361-4195",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "VA",
            "license": "12002006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shuprava Dhungana
• Diabetes and Endocrine Care of Virginia, LLC
• Lissette Dials, SLP
• Jesus Manuel Diaz Jr., D.C.
• Jill Renae Diaz, D.C.
• Caroline Diebler
• Samantha L Diehl, PA
• Kristy L Diffley, NURSE PRACTITIONER
• Christina Marie Digiacomo, LPC
• Irene Piol Diolazo Conlon, PT

• Developmentally Disabled Services Day Training Agency in Manassas, VA
• Providers in Manassas, VA by specialty
• 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 Aug 22, 2020; 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.