Organization · Type 2 NPI

Provident Arc LLC

Intellectual and/or Developmental Disabilities Residential Treatment Facility · Woodbridge, VA

NPI number 1285957761 Active

Practice location

17300 River Ridge Blvd, Suite 301
Woodbridge, VA 22191-5167

Call (703) 861-4409 Map

Specialties and licenses

TaxonomyCodeLicense
Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary 320600000X954 (VA)

Intellectual and/or Developmental Disabilities Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

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About NPI 1285957761

Provident Arc LLC's National Provider Identifier is 1285957761, issued on Mar 11, 2010. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Residential Treatment Facility (320600000X), and the practice location is in Woodbridge, VA. The record was last updated on Mar 11, 2010.