Organization
GREENFIELD ASSISTED LIVING OF STAFFORD LLC
Active
Other names
Greenfield Assisted Living of Stafford
Organization subpart
No
Provider details
NPI number
Authorized official
MATHEW PEPONIS (CEO)
(703) 962-9125
Entity
Organization
Contact information
Practice address
6312 SEVEN CORNERS CENTER #161, FALLS CHURCH, VA 22044
(703) 962-9125
(703) 237-5609
Mailing address
30 KINGS CREST DRIVE, STAFFORD, VA 22554
(540) 288-9353
(540) 288-8834
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
WLO-05-1103730
VA
Other
Enumeration date
12/01/2014
Last updated
12/01/2014
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