Provider Demographics
NPI:1891257416
Name:AVID CARE SERVICES, INC
Entity Type:Organization
Organization Name:AVID CARE SERVICES, INC
Other - Org Name:AVID CARE SERVICES, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES/CEO
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:AYORKOR
Authorized Official - Last Name:ADJETEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-343-5593
Mailing Address - Street 1:15110 KENTSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-4053
Mailing Address - Country:US
Mailing Address - Phone:703-343-5593
Mailing Address - Fax:801-346-1761
Practice Address - Street 1:15110 KENTSHIRE DR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-4053
Practice Address - Country:US
Practice Address - Phone:703-343-5593
Practice Address - Fax:801-346-1761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities