Provider Demographics
NPI:1205014347
Name:INDIVIDUAL DEVELOPMENT INC
Entity Type:Organization
Organization Name:INDIVIDUAL DEVELOPMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:RAGHUNANDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-518-0314
Mailing Address - Street 1:1420 N STREET NW
Mailing Address - Street 2:SUITE #9
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005
Mailing Address - Country:US
Mailing Address - Phone:202-518-0314
Mailing Address - Fax:202-518-9685
Practice Address - Street 1:3020 STANTON ROAD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020
Practice Address - Country:US
Practice Address - Phone:202-610-2724
Practice Address - Fax:202-610-1019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-31
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities