Provider Demographics
NPI:1740996941
Name:LOUDOUN CENTER FOR REHABILITATION AND NURSING LLC
Entity type:Organization
Organization Name:LOUDOUN CENTER FOR REHABILITATION AND NURSING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELAZAR
Authorized Official - Middle Name:
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-895-9122
Mailing Address - Street 1:1135 E VETERANS HWY
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-5090
Mailing Address - Country:US
Mailing Address - Phone:617-895-9122
Mailing Address - Fax:
Practice Address - Street 1:235 OLD WATERFORD RD NW
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-2117
Practice Address - Country:US
Practice Address - Phone:703-771-2841
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility