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General NPI Number Information
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NPI Number | 1093050304
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Entity Type | Organization
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Legal Business Name | MSH/HUNTER MILL OPERATING, LLC
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Dates
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Enumeration Date | 11/28/2012
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Last Update Date | 11/28/2012
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Provider Practice Location Address
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Address Line | 2863 HUNTER MILL RD
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City | OAKTON
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State | VA
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Zip | 22124-1702
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Country | US
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Telephone | 703-255-1006
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Fax | 703-255-1007
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Provider Business Mailing Address
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Address Line | 2863 HUNTER MILL RD
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City | HUNTER MILL
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State | VA
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Zip | 22124-1702
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Country | US
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Telephone | 703-255-1006
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Fax | 703-255-1007
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | LAURIE HENSLEY
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Credential |
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Telephone | 703-255-1006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | ALF 1082985-L151
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License Number State | VA
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