Provider Demographics
NPI:1497418602
Name:SUSAN RIGHTS HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:SUSAN RIGHTS HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JASS
Authorized Official - Middle Name:
Authorized Official - Last Name:TAGNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-640-1885
Mailing Address - Street 1:7910 SLIDELL LN
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22151-2439
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7910 SLIDELL LN
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22151-2439
Practice Address - Country:US
Practice Address - Phone:301-640-1885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-15
Last Update Date:2021-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities