Organization
INOVA HEALTH SYSTEM SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT HAGER (SENOIR ADMINISTRATOR)
(703) 279-4252
Entity
Organization
Contact information
Practice address
1800 CAMERON GLEN DR, RESTON, VA 20190-3308
(703) 834-5800
(703) 834-5905
Mailing address
2990 TELESTAR CT, SUITE 3LT, FALLS CHURCH, VA 22042-1207
(571) 423-5747
(571) 423-5703
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH2593
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004951794
—
VA
01
—
004960122
SPECIALIZED MEDICAID
VA
Enumeration date
11/06/2006
Last updated
11/18/2010
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