Organization
FAIRFAX FALLS CHURCH COMMUNITY SERVICE BOARD
Active
Parent organization
FAIRFAX COUNTY GOVT.
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAIRFAX COUNTY GOVT.
Authorized official
ROSALINE NANKAM (RN/ SUPERVISOR)
(703) 502-7005
Entity
Organization
Contact information
Practice address
4213 WALNEY RD, CHANTILLY, VA 20151-2923
(703) 502-7000
Mailing address
4213 WALNEY RD, CHANTILLY, VA 20151-2923
(703) 502-5005
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
0002052809
VA
Other
Enumeration date
12/08/2012
Last updated
12/08/2012
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