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General NPI Number Information
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NPI Number | 1841435286
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Entity Type | Organization
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Legal Business Name | FOR CHILDREN'S SAKE OF VIRGINIA
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Dates
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Enumeration Date | 12/15/2008
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Last Update Date | 07/17/2013
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Provider Practice Location Address
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Address Line | 14900 BOGLE DR STE 200
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City | CHANTILLY
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State | VA
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Zip | 20151-1756
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Country | US
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Telephone | 703-817-9890
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Fax | 571-321-0322
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Provider Business Mailing Address
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Address Line | 14900 BOGLE DR STE 200
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City | CHANTILLY
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State | VA
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Zip | 20151-1756
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Country | US
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Telephone | 703-817-9890
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Fax | 571-321-0322
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Authorized Official
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Title or Position | CEO
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Name | MRS. DEBORAH EVANS
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Credential | LCSW
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Telephone | 703-817-9890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | VA
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