Provider Demographics
NPI:1699199620
Name:CONTINUUM PEDIATRIC SERVICES LLC
Entity Type:Organization
Organization Name:CONTINUUM PEDIATRIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-506-0123
Mailing Address - Street 1:1651 OLD MEADOW RD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-4311
Mailing Address - Country:US
Mailing Address - Phone:703-506-0123
Mailing Address - Fax:703-734-1932
Practice Address - Street 1:1651 OLD MEADOW RD
Practice Address - Street 2:SUITE 600
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-4311
Practice Address - Country:US
Practice Address - Phone:703-506-0123
Practice Address - Fax:703-734-1932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-11
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care