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Organization

ICON COMMUNITY SERVICES, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ROBYN M FITZGERALD (EXECUTIVE DIRECTOR)
(703) 548-4048
Entity
Organization

Contact information

Practice address
1240 N PITT ST, SUITE LL, ALEXANDRIA, VA 22314-5600
(703) 548-4048
(703) 548-0198
Mailing address
1240 N PITT ST, SUITE LL, ALEXANDRIA, VA 22314-5600
(703) 548-4048
(703) 548-0198

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
06303001
VA

Other

Enumeration date
10/23/2006
Last updated
08/22/2020
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