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General NPI Number Information
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NPI Number | 1861999245
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Entity Type | Organization
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Legal Business Name | SZR ALEXANDRIA ASSISTED LIVING, LP
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Dates
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Enumeration Date | 04/11/2018
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Last Update Date | 04/11/2018
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Provider Practice Location Address
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Address Line | 3520 DUKE ST
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City | ALEXANDRIA
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State | VA
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Zip | 22304-6303
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Country | US
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Telephone | 703-212-9192
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Fax | 703-370-1592
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Provider Business Mailing Address
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Address Line | 3520 DUKE ST
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City | ALEXANDRIA
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State | VA
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Zip | 22304-6303
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Country | US
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Telephone | 703-212-9192
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Fax | 703-370-1592
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JULIE LANE
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Credential |
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Telephone | 703-212-9192
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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 | ALF1103939-L155
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License Number State | VA
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