Provider Demographics
NPI:1831574078
Name:TWENTY PACK MANAGEMENT CORPORATION
Entity type:Organization
Organization Name:TWENTY PACK MANAGEMENT CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:DENNISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-536-1060
Mailing Address - Street 1:5900 WILSON BLVD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205-1548
Mailing Address - Country:US
Mailing Address - Phone:703-536-1060
Mailing Address - Fax:703-444-8294
Practice Address - Street 1:5900 WILSON BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-1548
Practice Address - Country:US
Practice Address - Phone:703-536-1060
Practice Address - Fax:703-444-8294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VABLC-1000030930-05310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility