Healthcare Provider Details

I. General information

NPI: 1760247027
Provider Name (Legal Business Name): ASSURANCE HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2024
Last Update Date: 05/16/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15312 LORD CULPEPER CT
WOODBRIDGE VA
22191-4935
US

IV. Provider business mailing address

16354 KRAMER ESTATE DR
WOODBRIDGE VA
22191-6000
US

V. Phone/Fax

Practice location:
  • Phone: 703-485-5156
  • Fax: 703-583-5555
Mailing address:
  • Phone: 703-485-5156
  • Fax: 703-583-5555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER PATTERSON
Title or Position: ADMINISTRATION
Credential:
Phone: 703-485-5156