# SCARLET HAVEN ON AGING, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Scarlet Haven for the Aging
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598169872
- **Authorized official:** CYNTHIA ANN BARDWELL (CHIEF ADMINISTRATIVE OFFICER)
- **Authorized official phone:** (703) 490-1197

## Contact information

- **Practice address:** 1346 OLD BRIDGE RD, SUITE 100, WOODBRIDGE, VA 22192-2743
- **Practice address phone:** (703) 490-1197
- **Practice address fax:** (703) 890-3122
- **Mailing address:** 1346 OLD BRIDGE RD, SUITE 100, WOODBRIDGE, VA 22192-2743
- **Mailing address phone:** (703) 490-1197
- **Mailing address fax:** (703) 890-3122

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 10/15/2014
- **Last updated:** 10/15/2014