Provider Demographics
NPI:1285280271
Name:GALAXY RESIDENTIAL SERVICES LLC
Entity type:Organization
Organization Name:GALAXY RESIDENTIAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EBIERE
Authorized Official - Middle Name:
Authorized Official - Last Name:LLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-945-1565
Mailing Address - Street 1:7900 ANDRUS RD STE 12
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22306-3170
Mailing Address - Country:US
Mailing Address - Phone:703-945-1565
Mailing Address - Fax:571-777-5068
Practice Address - Street 1:7900 ANDRUS RD STE 12
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22306-3170
Practice Address - Country:US
Practice Address - Phone:703-945-1565
Practice Address - Fax:571-777-5068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health