# INOVA HEALTH SYSTEM SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376622688
- **Authorized official:** MR. ROBERT HAGER (SENOIR ADMINISTRATOR)
- **Authorized official phone:** (703) 279-4252

## Contact information

- **Practice address:** 1800 CAMERON GLEN DR, RESTON, VA 20190-3308
- **Practice address phone:** (703) 834-5800
- **Practice address fax:** (703) 834-5905
- **Mailing address:** 2990 TELESTAR CT, SUITE 3LT, FALLS CHURCH, VA 22042-1207
- **Mailing address phone:** (571) 423-5747
- **Mailing address fax:** (571) 423-5703

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH2593 | VA | Yes |

## Other

- **Enumeration date:** 11/06/2006
- **Last updated:** 11/18/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004951794 | — | VA |
| 01 | — | 004960122 | SPECIALIZED MEDICAID | VA |