MEDICARE: UNITED METHODIST FAMILY SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility	64114001	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598974669
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITED METHODIST FAMILY SERVICES

Provider Business Mailing Address
First Line	:	13525 LELAND RD
Second Line	:
City	:	CENTREVILLE
State	:	VA
Zip	:	20120-2037
Country	:	US
Telephone Number	:	703-222-3558
Fax Number	:	703-803-7130

Provider Business Practice Location Address
First Line	:	13525 LELAND RD
Second Line	:
City	:	CENTREVILLE
State	:	VA
Zip	:	20120-2037
Country	:	US
Telephone Number	:	703-222-3558
Fax Number	:	703-803-7130

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	MR. JAY ZIEHL
Credential	:
Telephone Number	:	804-254-9469

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	06/07/2013

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Directions to “UNITED METHODIST FAMILY SERVICES ” Practice Location

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