Provider Demographics
NPI:1518671486
Name:SANDSTONE CARE VIRGINIA, LLC
Entity Type:Organization
Organization Name:SANDSTONE CARE VIRGINIA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARCELLO
Authorized Official - Middle Name:
Authorized Official - Last Name:LA ROCCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-372-1490
Mailing Address - Street 1:7555 E HAMPDEN AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-4832
Mailing Address - Country:US
Mailing Address - Phone:888-850-1890
Mailing Address - Fax:888-850-1860
Practice Address - Street 1:15100 ENTERPRISE CT
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-1228
Practice Address - Country:US
Practice Address - Phone:703-686-5753
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No251S00000XAgenciesCommunity/Behavioral Health