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Organization
INOVA HEALTH SYSTEM SERVICES
Active
Organization
INOVA HEALTH SYSTEM SERVICES
Active
Other names
COMMONWEALTH CARE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT HAGER (SENIOR ADMINSTRATOR)
(703) 279-4252
Entity
Organization
Contact information
Practice address
4315 CHAIN BRIDGE RD, FAIRFAX, VA 22030-3061
(703) 934-5000
(703) 934-5092
Mailing address
2990 TELESTAR CT, SUITE 3LT, FALLS CHURCH, VA 22042-1207
(571) 423-5747
(571) 423-5703
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH2594
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004951743
—
VA
05
—
004960131
—
VA
Enumeration date
02/22/2007
Last updated
11/18/2010
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