Organization
FAIRFAX COUNTY, VIRGINIA
Active
Organization
FAIRFAX COUNTY, VIRGINIA
Active
Other names
Fairfax Falls Church Community Services Board - DD Services
Organization subpart
No
Provider details
NPI number
Authorized official
DARYL WASHINGTON (EXECUTIVE DIRECTOR)
(703) 324-7000
Entity
Organization
Contact information
Practice address
12011 GOVERNMENT CENTER PKWY, SUITE 836, FAIRFAX, VA 22035-1100
(703) 324-7000
(703) 324-7092
Mailing address
12000 GOVERNMENT CENTER PKWY, SUITE 552, FAIRFAX, VA 22035-0001
(703) 324-3360
(703) 324-4573
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
113
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004945620
—
VA
Enumeration date
07/11/2006
Last updated
04/01/2021
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