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Organization

DIRECTOR OF FINANCE-COUNTY OF FAIRFAX VA

Active
Parent organization
COUNTY OF FAIRFAX, VIRGINIA
Other names
Early Intervention Services, Fairfax-Falls Church CSB
Organization subpart
Yes

Provider details

NPI number
Legal business name
COUNTY OF FAIRFAX, VIRGINIA
Authorized official
BRYAN J HILL (COUNTY EXECUTIVE)
(703) 324-2536
Entity
Organization

Contact information

Practice address
3750 BLENHEIM BLVD, FAIRFAX, VA 22030-1806
(703) 246-7121
(703) 653-1385
Mailing address
12000 GOVERNMENT CENTER PKWY, SUITE 552, FAIRFAX, VA 22035-0001
(703) 324-3360
(703) 324-4573

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
261QM1300X
Multi-Specialty Clinic/Center
113
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002193312002
UNITED HEALTHCARE
VA
05
004979737
VA
01
113512
KAISER PERMANENTE
VA
01
191539
ANTHEM
VA
01
191540
ANTHEM
VA
01
191541
ANTHEM
VA
01
293450
AMERIGROUP
VA
Enumeration date
07/08/2006
Last updated
10/30/2023
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