Calvary Healthcare LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

900-01-001 Issued in VA

Legal business name

CALVARY HEALTHCARE LLC

Practice address

10802 Monticello Dr
Great Falls, VA 22066-4223

Phone

(301) 335-8424

NPI assigned

Jan 21, 2009

Last updated

Apr 16, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rosemary H Kufuor, RN, BSN, MBA

Title

Administrator

Phone

(301) 335-8424

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1232496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239840000000",
    "number": "1780822254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 MIDDLEFIELD CT",
            "city": "DENVILLE",
            "state": "NJ",
            "postal_code": "078343463",
            "telephone_number": "301-335-8424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10802 MONTICELLO DR",
            "city": "GREAT FALLS",
            "state": "VA",
            "postal_code": "220664223",
            "telephone_number": "301-335-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALVARY HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-21",
        "last_updated": "2009-04-16",
        "status": "A",
        "authorized_official_last_name": "KUFUOR",
        "authorized_official_first_name": "ROSEMARY",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "301-335-8424",
        "authorized_official_credential": "RN, BSN, MBA"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "VA",
            "license": "900-01-001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Communitylaboratory

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Great Falls, VA
• Providers in Great Falls, VA by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.