Healthcare Provider Details

I. General information

NPI: 1376866046
Provider Name (Legal Business Name): ACHIEVEMENT REHABILITATION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2010
Last Update Date: 03/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3855 CENTERVIEW DR SUITE 100
CHANTILLY VA
20151-3285
US

IV. Provider business mailing address

2841 HARTLAND RD SUITE 307
FALLS CHURCH VA
22043-3500
US

V. Phone/Fax

Practice location:
  • Phone: 703-431-3202
  • Fax:
Mailing address:
  • Phone: 703-333-5288
  • Fax: 703-333-5952

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHCO-326PC
License Number StateVA

VIII. Authorized Official

Name: MS. BETTY SALE COREY
Title or Position: DIRECTOR OF CLINICAL SERVICES
Credential: RN
Phone: 703-333-5288