E & E RESIDENTIAL SUPPORT PROFESSIONALS LLC (NPI# 1942800594) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942800594 |
| Entity Type | Organization |
| Organization Name | E & E RESIDENTIAL SUPPORT PROFESSIONALS LLC |
| Other Organization Name | E & E RESIDENTIAL SUPPORT PROFESSIONALS, LLC |
| Practice Address |
15337 Barnabas Trl Woodbridge VA 22193-5566 |
| Practice Telephone | 5714846464 |
| Mailing Telephone | 5714846464 |
| Enumeration Date | 2020-10-30 |
| Last Update Date | 2020-10-30 |
| Authorized Official Name | KENNETH KWEKU BANSAH (PRESIDENT/CEO) |
| Authorized Official Telephone | 5714846464 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| E & E Residential Support Professionals, LLC | Doing Business As Name - Organization |
| Street Address |
15337 BARNABAS TRL |
| City | WOODBRIDGE |
| State | VA |
| Zip Code | 22193-5566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023627452 | Elyon Home Healthcare, LLC. | Home Health | 15337 Barnabas Trl, Woodbridge, VA 22193-5566 | 2020-07-31 |
| 1043820319 | Annette Sarpong | Registered Nurse | 15337 Barnabas Trl, Woodbridge, VA 22193-5566 | 2020-08-03 |
| 1407470750 | Kenneth K Bansah | Adult Companion | 15337 Barnabas Trl, Woodbridge, VA 22193-5566 | 2020-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083111702 | Bethiana Magallanes White | Speech-Language Pathologist | 14450 Brook Dr, Woodbridge, VA 22193 | 2018-04-09 |
| 1982111449 | Frances Davis | Social Worker | 4196 Merchant Plaza Apt 632, Woodbridge, VA 22193 | 2018-01-05 |
| 1427421627 | Woodbridge Therapy Group LLC | Counselor | 12721 Darby Brooke Ct., Suite 102, Woodbridge, VA 22193 | 2015-11-10 |
| 1972981090 | Lifeline Home Health Inc | Community/Behavioral Health | 4309 Kenwood Dr, Woodbridge, VA 22193 | 2015-05-08 |
| 1588056139 | Lifelong Good Health LLC | Clinic/Center | 5721 Rhode Isalnd Drive, Woodbridge, VA 22193 | 2015-02-19 |
| 1639560378 | Tara Devi Smith | Psychologist | 13855 Hedgewood Drive, #245, Woodbridge, VA 22193 | 2015-02-17 |
| 1710396114 | Allanna Harrison | Speech-Language Pathologist | 15792 Beau Ridge Dr., Woodbridge, VA 22193 | 2014-08-11 |
| 1659788909 | Lifelong Good Health | Clinic/Center | 5721 Rhode Island Dr, Woodbridge, VA 22193 | 2014-07-18 |
| 1952731960 | Corrieann Marie Avila | Social Worker | 12721 Darby Brooke Court, Suite 102, Woodbridge, VA 22193 | 2013-11-13 |
| 1972881019 | Ockhee Jung | Acupuncturist | 14174 Rizdon Ct, Woodbridge, VA 22193 | 2011-07-22 |
| Find all providers in zip 22193 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891327417 | Perfect Home Support, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 13662 Office Pl Ste 104, Woodbridge, VA 22192-4217 | 2020-02-11 |
| 1164076790 | Home Away Residential Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4304 Eldorado Dr, Woodbridge, VA 22193-2716 | 2019-07-31 |
| 1831755958 | Blessed Support Professionals, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 14511 Jefferson Davis Hwy # A, Woodbridge, VA 22191-2807 | 2019-05-14 |
| 1588229306 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1482 Rahway Ave, Apt 103, Woodbridge, NJ 07001 | 2019-05-07 |
| 1871113936 | Applied Group Home Solutions LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1986 Opitz Blvd, Woodbridge, VA 22191-3304 | 2020-04-19 |
| 1740834068 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1482 Rahway Avenue, Apt 227, Woodbridge, NJ 17001-0850 | 2019-07-25 |
| 1285288688 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1482 Rahway Avenue, Apt. 106, Woodbridge, NJ 17001 | 2019-07-25 |
| 1689227019 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1482 Rahway Avenue, Apt 117, Woodbridge, NJ 17001-0850 | 2019-07-24 |
| 1497308829 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1482 Rahway Avenue, Apt 113, Woodbridge, NJ 08501-0850 | 2019-07-24 |
| 1790338119 | Pennreach | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1482 Rahway Avenue, 104, Woodbridge, NJ 17001-0850 | 2019-07-24 |
| Find all providers in WOODBRIDGE | ||||
| City | WOODBRIDGE |
| Zip Code | 22193 |
Please comment or provide details below to improve the information on E & E RESIDENTIAL SUPPORT PROFESSIONALS LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.