Organization
INOVA HEALTH SYSTEM SERVICES
Active
Other names
COMMONWEALTH CARE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT HAGER (SENIOR ADMINSTRATOR)
(703) 279-4252
Entity
Organization
Contact information
Practice address
4315 CHAIN BRIDGE RD, FAIRFAX, VA 22030-3061
(703) 934-5000
(703) 934-5092
Mailing address
2990 TELESTAR CT, SUITE 3LT, FALLS CHURCH, VA 22042-1207
(571) 423-5747
(571) 423-5703
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH2594
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004951743
—
VA
05
—
004960131
—
VA
Enumeration date
02/22/2007
Last updated
11/18/2010
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