Organization
SERVICESOURCE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRUCE PATTERSON (SENIOR VICE PRESIDENT OF METRO REGI)
(703) 461-6140
Entity
Organization
Contact information
Practice address
6295 EDSALL RD STE 175, ALEXANDRIA, VA 22312-2670
(703) 461-6000
(703) 461-3906
Mailing address
6295 EDSALL RD STE 175, ALEXANDRIA, VA 22312-2670
(703) 461-6000
(703) 461-3906
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
262
VA
Other
Enumeration date
08/09/2006
Last updated
06/17/2008
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