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General NPI Number Information
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NPI Number | 1710355359
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Entity Type | Organization
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Legal Business Name | CERTIFIED SKILLED NURSING SERVICES
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Dates
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Enumeration Date | 09/14/2015
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Last Update Date | 09/14/2015
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Provider Practice Location Address
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Address Line | 10560 MAIN ST SUITE 503
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City | FAIRFAX
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State | VA
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Zip | 22030-7182
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Country | US
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Telephone | 703-273-2055
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Fax | 703-273-0575
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Provider Business Mailing Address
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Address Line | 10560 MAIN ST SUITE 503
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City | FAIRFAX
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State | VA
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Zip | 22030-7182
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Country | US
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Telephone | 703-273-2055
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Fax | 703-273-0575
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | HAPPINESS EMEJURU
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Credential |
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Telephone | 703-843-6185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HCO 161292
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License Number State | VA
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