# MOUNT VERNON NURSING CENTER ASSOCIATES, LLLP

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

## Provider details

- **NPI number:** 1497761175
- **Authorized official:** MR. ROBERT K DEMARIA (ADMINISTRATOR)
- **Authorized official phone:** (703) 360-4000

## Contact information

- **Practice address:** 8111 TIS WELL DR, ALEXANDRIA, VA 22306-3211
- **Practice address phone:** (703) 360-4000
- **Practice address fax:** (703) 360-9325
- **Mailing address:** 8111 TIS WELL DR, ALEXANDRIA, VA 22306-3211
- **Mailing address phone:** (703) 360-4000
- **Mailing address fax:** (703) 360-9325

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | NH2634 | VA | — |
| 314000000X | Skilled Nursing Facility | NH2634 | VA | Yes |

## Other

- **Enumeration date:** 08/01/2006
- **Last updated:** 09/28/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004952111 | — | VA |