Organization
MANOR CARE-FAIR OAKS OF FAIRFAX VA LLC
Active
Other names
ProMedica Skilled Nursing and Rehabilitation (Fair Oaks)
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTIN D ALLEN (DIRECTOR)
(419) 252-5734
Entity
Organization
Contact information
Practice address
12475 LEE JACKSON MEMORIAL HWY, FAIRFAX, VA 22033-2803
(703) 352-7172
(703) 218-3200
Mailing address
333 N SUMMIT ST, TOLEDO, OH 43604-2615
(419) 252-5500
(877) 385-9446
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH2619
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861437154
—
VA
Enumeration date
06/19/2006
Last updated
01/24/2022
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