Organization
MOUNT VERNON NURSING CENTER ASSOCIATES, LLLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT K DEMARIA (ADMINISTRATOR)
(703) 360-4000
Entity
Organization
Contact information
Practice address
8111 TIS WELL DR, ALEXANDRIA, VA 22306-3211
(703) 360-4000
(703) 360-9325
Mailing address
8111 TIS WELL DR, ALEXANDRIA, VA 22306-3211
(703) 360-4000
(703) 360-9325
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
NH2634
VA
314000000X
Skilled Nursing Facility
Primary
NH2634
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004952111
—
VA
Enumeration date
08/01/2006
Last updated
09/28/2010
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