| NPI | 1386636116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE BAINUM CARLSON Executive Administrator 703-273-7705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: VA NH2552) |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2015-08-07 |