Organization
BLACKSTONE MARY IVY HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ATO K SMITH-MENSAH (ADMINISTRATOR)
(571) 234-3699
Entity
Organization
Contact information
Practice address
8951 BIRCH BAY CIR, LORTON, VA 22079-5660
(571) 234-3699
Mailing address
8951 BIRCH BAY CIR, LORTON, VA 22079-5660
(571) 234-3699
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
02/13/2024
Last updated
02/13/2024
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