Provider Demographics
NPI:1285217844
Name:RIGHT PATH VISION, INC.
Entity Type:Organization
Organization Name:RIGHT PATH VISION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KHADIJA
Authorized Official - Middle Name:B
Authorized Official - Last Name:JALLOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-486-7038
Mailing Address - Street 1:9529 LOMOND DR
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20109-3154
Mailing Address - Country:US
Mailing Address - Phone:240-486-7038
Mailing Address - Fax:
Practice Address - Street 1:9529 LOMOND DR
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-3154
Practice Address - Country:US
Practice Address - Phone:240-486-7038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-03
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA3469OtherDEPARTMENT OF BEHAVIORAL HEALTH & DEVELOPMENTAL SERVICES