Provider Demographics
NPI:1124913421
Name:ROCK CREEK HOMES LLC
Entity type:Organization
Organization Name:ROCK CREEK HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXEC
Authorized Official - Prefix:
Authorized Official - First Name:LILY
Authorized Official - Middle Name:
Authorized Official - Last Name:DOBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-839-2850
Mailing Address - Street 1:4627 ASPEN HILL CT
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-3573
Mailing Address - Country:US
Mailing Address - Phone:703-839-2850
Mailing Address - Fax:
Practice Address - Street 1:64A SYCOLIN RD SE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-4105
Practice Address - Country:US
Practice Address - Phone:540-974-2090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services