Provider Demographics
NPI:1104204262
Name:OUTSTANDING POSSIBILITIES REVEALED, LLP
Entity Type:Organization
Organization Name:OUTSTANDING POSSIBILITIES REVEALED, LLP
Other - Org Name:OUTSTANDING POSSIBILITIES REVEALED LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALTHEA
Authorized Official - Middle Name:
Authorized Official - Last Name:AZU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-806-1711
Mailing Address - Street 1:3022 JAVIER RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4645
Mailing Address - Country:US
Mailing Address - Phone:202-888-6533
Mailing Address - Fax:
Practice Address - Street 1:3022 JAVIER RD
Practice Address - Street 2:SUITE 130
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4645
Practice Address - Country:US
Practice Address - Phone:202-888-6533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-09
Last Update Date:2016-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services