Healthcare Provider Details

I. General information

NPI: 1619265360
Provider Name (Legal Business Name): VINSON HALL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2011
Last Update Date: 07/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6251 OLD DOMINION DR
MC LEAN VA
22101-4827
US

IV. Provider business mailing address

6251 OLD DOMINION DR
MC LEAN VA
22101-4827
US

V. Phone/Fax

Practice location:
  • Phone: 703-536-4344
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberFLO10600L154
License Number StateVA

VIII. Authorized Official

Name: MR. ROBERT CLEMENTS
Title or Position: CFO
Credential:
Phone: 703-538-2971