Anna & Raphael Residential Services, LLC

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

ANNA & RAPHAEL RESIDENTIAL SERVICES, LLC

Practice address

13705 Mapledale Ave
Woodbridge, VA 22193-4455

Phone

(571) 209-0013

NPI assigned

Jul 21, 2023

Organization subpart

No

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

Authorized official

Name

Bibiiana Ezeonyim

Title

Administrator

Phone

(240) 426-0447

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1689897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689897600000",
    "number": "1538849773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 PIDGEON HILL DR STE 240",
            "city": "STERLING",
            "state": "VA",
            "postal_code": "201656176",
            "telephone_number": "571-209-0013",
            "fax_number": "571-313-0196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13705 MAPLEDALE AVE",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221934455",
            "telephone_number": "571-209-0013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNA & RAPHAEL RESIDENTIAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-21",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A",
        "authorized_official_last_name": "EZEONYIM",
        "authorized_official_first_name": "BIBIIANA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "240-426-0447"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.