Provider Demographics
NPI:1043079957
Name:UNIQUE RESIDENTIAL LLC
Entity Type:Organization
Organization Name:UNIQUE RESIDENTIAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TERENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:NUMVI
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:703-884-6202
Mailing Address - Street 1:4410 POTOMAC HIGHLANDS CIR
Mailing Address - Street 2:
Mailing Address - City:TRIANGLE
Mailing Address - State:VA
Mailing Address - Zip Code:22172-1789
Mailing Address - Country:US
Mailing Address - Phone:703-884-6202
Mailing Address - Fax:
Practice Address - Street 1:4410 POTOMAC HIGHLANDS CIR
Practice Address - Street 2:
Practice Address - City:TRIANGLE
Practice Address - State:VA
Practice Address - Zip Code:22172-1789
Practice Address - Country:US
Practice Address - Phone:703-884-6202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services