Provider Demographics
NPI:1972592533
Name:THE TEMPLE FOUNDATION INC.
Entity Type:Organization
Organization Name:THE TEMPLE FOUNDATION INC.
Other - Org Name:THE VIRGINIAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF HEALTH CARE SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:KNEISLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:703-277-7242
Mailing Address - Street 1:9229 ARLINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-2504
Mailing Address - Country:US
Mailing Address - Phone:703-385-0555
Mailing Address - Fax:703-591-9368
Practice Address - Street 1:9229 ARLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2504
Practice Address - Country:US
Practice Address - Phone:703-385-0555
Practice Address - Fax:703-591-9368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-17
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VANH2712314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4953193Medicaid
VA4953193Medicaid