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General NPI Number Information
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NPI Number | 1700085479
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Entity Type | Organization
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Legal Business Name | OTRADA ADULT DAY HEALTHCARE CENTER,
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Dates
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Enumeration Date | 07/13/2007
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Last Update Date | 11/05/2019
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Provider Practice Location Address
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Address Line | 8530 AMANDA PL
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City | VIENNA
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State | VA
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Zip | 22180-6873
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Country | US
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Telephone | 703-992-6688
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Fax | 703-942-6776
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Provider Business Mailing Address
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Address Line | 8530 AMANDA PL
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City | VIENNA
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State | VA
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Zip | 22180-6873
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Country | US
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Telephone | 703-942-6688
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DONG CHUL CHOI
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Credential |
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Telephone | 703-498-0050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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