Provider Demographics
NPI:1669525986
Name:VINSON HALL CORPORATION
Entity type:Organization
Organization Name:VINSON HALL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO, EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:RADM, SHCE,USN (RET)
Authorized Official - Phone:703-538-3065
Mailing Address - Street 1:6251 OLD DOMINION DR
Mailing Address - Street 2:
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-4827
Mailing Address - Country:US
Mailing Address - Phone:703-538-4344
Mailing Address - Fax:703-538-2992
Practice Address - Street 1:6251 OLD DOMINION DR
Practice Address - Street 2:HEALTH SERVICES DEPARTMENT
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-4827
Practice Address - Country:US
Practice Address - Phone:703-538-2993
Practice Address - Fax:703-538-2992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA=========OtherTAXPAYER IDENTIFICATION N
VA=========OtherTAXPAYER IDENTIFICATION N
VAW89313Medicare UPIN