Provider Demographics
NPI:1457862989
Name:VIRGINIA HOME - ASSISTED LIVING - CARE SERVICES
Entity Type:Organization
Organization Name:VIRGINIA HOME - ASSISTED LIVING - CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:703-350-2562
Mailing Address - Street 1:1390 CHAIN BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3904
Mailing Address - Country:US
Mailing Address - Phone:800-460-1482
Mailing Address - Fax:703-687-6176
Practice Address - Street 1:40543 COURTLAND FARM LANE
Practice Address - Street 2:
Practice Address - City:ALDIE
Practice Address - State:VA
Practice Address - Zip Code:20105-2010
Practice Address - Country:US
Practice Address - Phone:703-895-5358
Practice Address - Fax:703-895-5358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-24
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty