Organization
ENVOY OF WOODBRIDGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH USSERY (VP)
(407) 571-1550
Entity
Organization
Contact information
Practice address
14906 JEFFERSON DAVIS HWY, WOODBRIDGE, VA 22191-4016
(703) 491-6167
Mailing address
14906 JEFFERSON DAVIS HWY, WOODBRIDGE, VA 22191-4016
(703) 491-6167
(703) 491-6969
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205089240
—
VA
05
—
4953614
—
VA
Enumeration date
11/03/2008
Last updated
11/27/2023
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