Provider Demographics
NPI:1104365642
Name:ARLINGTON COUNTY GOVERNMENT
Entity Type:Organization
Organization Name:ARLINGTON COUNTY GOVERNMENT
Other - Org Name:WALTER REED ADULT DAY HEALTHCARE CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DIGERONIMO
Authorized Official - Suffix:
Authorized Official - Credentials:CTRS
Authorized Official - Phone:703-228-5340
Mailing Address - Street 1:2909 16TH ST S
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-4974
Mailing Address - Country:US
Mailing Address - Phone:703-228-5340
Mailing Address - Fax:
Practice Address - Street 1:2909 16TH ST S
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-4974
Practice Address - Country:US
Practice Address - Phone:703-228-5340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARLINGTON COUNTY GOVERNMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAADC113670-L155261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00087301302OtherAPI