# INOVA HEALTH SYSTEM SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** COMMONWEALTH CARE CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912032012
- **Authorized official:** ROBERT HAGER (SENIOR ADMINSTRATOR)
- **Authorized official phone:** (703) 279-4252

## Contact information

- **Practice address:** 4315 CHAIN BRIDGE RD, FAIRFAX, VA 22030-3061
- **Practice address phone:** (703) 934-5000
- **Practice address fax:** (703) 934-5092
- **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 | NH2594 | VA | Yes |

## Other

- **Enumeration date:** 02/22/2007
- **Last updated:** 11/18/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004951743 | — | VA |
| 05 | — | 004960131 | — | VA |