Provider Demographics
NPI:1801630801
Name:CATHOLIC CHARATIES DIOCESE OF ARLINGTON
Entity type:Organization
Organization Name:CATHOLIC CHARATIES DIOCESE OF ARLINGTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUEVANO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:703-420-8992
Mailing Address - Street 1:9380 FORESTWOOD LN STE B
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4735
Mailing Address - Country:US
Mailing Address - Phone:703-335-2779
Mailing Address - Fax:703-420-8993
Practice Address - Street 1:9380 FORESTWOOD LN STE B
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4735
Practice Address - Country:US
Practice Address - Phone:703-335-2779
Practice Address - Fax:703-420-8993
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CATHOLIC CHARATIES DIOCESE OF ARLINGTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-24
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty