Provider Demographics
NPI:1013618941
Name:ROSSYBRIGHT HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:ROSSYBRIGHT HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KIZITO
Authorized Official - Middle Name:FONJONG
Authorized Official - Last Name:TEMBU
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:443-622-9330
Mailing Address - Street 1:5680 KING CENTRE DR STE 600
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315-5755
Mailing Address - Country:US
Mailing Address - Phone:703-647-3886
Mailing Address - Fax:703-738-7814
Practice Address - Street 1:5709 CEDAR WALK APT 201
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20121-4528
Practice Address - Country:US
Practice Address - Phone:443-622-9330
Practice Address - Fax:703-738-7814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-16
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities