Healthcare Provider Details

I. General information

NPI: 1659839389
Provider Name (Legal Business Name): FFI VIRGINIAN TENANT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2019
Last Update Date: 03/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9229 ARLINGTON BLVD
FAIRFAX VA
22031-2504
US

IV. Provider business mailing address

200 S 10TH ST STE 1600
RICHMOND VA
23219-4061
US

V. Phone/Fax

Practice location:
  • Phone: 703-385-0555
  • Fax:
Mailing address:
  • Phone: 804-420-6358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: CURT SCHALLER
Title or Position: VICE PRESIDENT
Credential:
Phone: 312-533-2728