Organization
MVLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. APRIL PINCH-KEELER (PRESIDENT)
(703) 569-3900
Entity
Organization
Contact information
Practice address
7420 FULLERTON ROAD, SUITE 110, SPRINGFIELD, VA 22153-2836
(703) 569-3900
(703) 569-3932
Mailing address
7420 FULLERTON RD STE 110, SPRINGFIELD, VA 22153-2836
(703) 569-3900
(703) 569-3932
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
147-02-006
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004945999
PROVIDER NUMBER
VA
Enumeration date
03/21/2006
Last updated
02/18/2009
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