OrganizationActive
Individual Development Inc
NPI 1306023759 · Intellectual Disabilities Intermediate Care Facility · Washington, DC
Provider details
- NPI number
- 1306023759
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Ronald Raghunandan, Cfo Ceo(202) 518-0314
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
4515 Edson Place Ne
Washington, DC 20019
Phone: (202) 396-8117
Fax: (202) 396-8126
Approximate (ZIP-level) locationGet directions
Mailing address
1420 N Street Nw
Washington, DC 20005
Registry dates
- Enumerated
- 2008-01-29
- Last updated
- 2008-01-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.