Provider Demographics
NPI:1528588076
Name:ALMOSTHOME RESIDENTIAL SERVICES, LLC
Entity Type:Organization
Organization Name:ALMOSTHOME RESIDENTIAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:IVO
Authorized Official - Middle Name:
Authorized Official - Last Name:NGOSONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-910-7081
Mailing Address - Street 1:1940 OPITZ BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-3304
Mailing Address - Country:US
Mailing Address - Phone:703-910-7081
Mailing Address - Fax:703-910-7199
Practice Address - Street 1:5879 HARVEST SUN RD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-6034
Practice Address - Country:US
Practice Address - Phone:703-910-7081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-26
Last Update Date:2017-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251B00000XAgenciesCase Management
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2489Medicaid