Provider Demographics
NPI:1164241097
Name:ALL-INCLUSIVE ADULT DAY SUPPORT LLC
Entity type:Organization
Organization Name:ALL-INCLUSIVE ADULT DAY SUPPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SOPHIA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DOUMBIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-245-5608
Mailing Address - Street 1:205 YOAKUM PKWY UNIT 1419
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-3855
Mailing Address - Country:US
Mailing Address - Phone:804-471-3889
Mailing Address - Fax:
Practice Address - Street 1:205 YOAKUM PKWY UNIT 1419
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-3855
Practice Address - Country:US
Practice Address - Phone:804-471-3889
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities