Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lily Rose Residential Services LLC

Organization Intellectual and/or Developmental Disabilities Residential Treatment Facility · NPI 1992472120

Lily Rose Residential Services LLC is an Intellectual and/or Developmental Disabilities Residential Treatment Facility in Woodbridge, Virginia. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3102 Golansky Blvd Ste 202
Woodbridge, VA 22192-4244
Phone: (703) 401-4133
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Intellectual and/or Developmental Disabilities Residential Treatment Facility (primary) Taxonomy 320600000X

Record details

NPI number1992472120
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Chikata Khyne-Sam — Director · (703) 401-4133
NPI enumeratedAugust 25, 2021
Last updated in NPPESAugust 25, 2021
Certification dateAugust 25, 2021
Mailing address3102 Golansky Blvd Ste 202, Woodbridge, VA 22192-4244

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