Healthcare Provider Details

I. General information

NPI: 1164674578
Provider Name (Legal Business Name): ARLINGTON COUNTY GOVERNMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2008
Last Update Date: 10/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 N GEORGE MASON DR
ARLINGTON VA
22205-3675
US

IV. Provider business mailing address

1725 N GEORGE MASON DR
ARLINGTON VA
22205-3675
US

V. Phone/Fax

Practice location:
  • Phone: 703-228-5150
  • Fax:
Mailing address:
  • Phone: 703-228-5150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number0001126240
License Number StateVA

VIII. Authorized Official

Name: MR. WALTER TEJADA
Title or Position: CHAIRMAN ARLINGTON COUNTY BOARD
Credential:
Phone: 703-228-3130