Provider Demographics
NPI:1093050304
Name:MSH/HUNTER MILL OPERATING, LLC
Entity Type:Organization
Organization Name:MSH/HUNTER MILL OPERATING, LLC
Other - Org Name:SUNRISE AT HUNTER MILL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HENSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-255-1006
Mailing Address - Street 1:2863 HUNTER MILL RD
Mailing Address - Street 2:
Mailing Address - City:HUNTER MILL
Mailing Address - State:VA
Mailing Address - Zip Code:22124-1702
Mailing Address - Country:US
Mailing Address - Phone:703-255-1006
Mailing Address - Fax:703-255-1007
Practice Address - Street 1:2863 HUNTER MILL RD
Practice Address - Street 2:
Practice Address - City:OAKTON
Practice Address - State:VA
Practice Address - Zip Code:22124-1702
Practice Address - Country:US
Practice Address - Phone:703-255-1006
Practice Address - Fax:703-255-1007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-28
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAALF 1082985-L151310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility