Provider Demographics
NPI:1134969553
Name:IN GOOD HANDS WITH NOAHS ARC LLC
Entity type:Organization
Organization Name:IN GOOD HANDS WITH NOAHS ARC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KALITA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-252-8087
Mailing Address - Street 1:4682 NEWLINE RD
Mailing Address - Street 2:
Mailing Address - City:GUM SPRING
Mailing Address - State:VA
Mailing Address - Zip Code:23065
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4682 NEWLINE RD
Practice Address - Street 2:
Practice Address - City:GUM SPRING
Practice Address - State:VA
Practice Address - Zip Code:23065
Practice Address - Country:US
Practice Address - Phone:804-252-8087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities