OrganizationActive
Provident Arc LLC
NPI 1285957761 · Intellectual and/or Developmental Disabilities Residential Treatment Facility · Woodbridge, VA
Provider details
- NPI number
- 1285957761
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Reynaldo Roundtree, Co-Owner(703) 861-4409
- License
- 954 (VA)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityPrimary320600000XLicense 954 (VA)
Residential Treatment Facilities
Profile Score
Detailed profile(84/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
17300 River Ridge Blvd
Suite 301
Woodbridge, VA 22191-5167
Phone: (703) 861-4409
Street-level locationGet directions
Mailing address
17300 River Ridge Blvd
Woodbridge, VA 22191-5167
Registry dates
- Enumerated
- 2010-03-11
- Last updated
- 2010-03-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.