MEDICARE: THE ARC OF NORTHERN VIRGINIA

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	251B00000X	Case Management Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0087438195	OTHER	VA	API
2	0100303079	OTHER	VA	API

General Provider Information

NPI Number	:	1740426543
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE ARC OF NORTHERN VIRGINIA

Provider Business Mailing Address
First Line	:	98 N WASHINGTON ST
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22046-4514
Country	:	US
Telephone Number	:	703-532-3214
Fax Number	:	703-533-3398

Provider Business Practice Location Address
First Line	:	98 N WASHINGTON ST
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22046-4514
Country	:	US
Telephone Number	:	703-532-3214
Fax Number	:	703-533-3398

Authorized Official
Title or Position	:	DIRECTOR OF PROGRAMS AND SERVICES
Name	:	CARRIE FREY
Credential	:
Telephone Number	:	703-532-3214

Provider Enumeration Date	:	12/29/2008
Last Update Date	:	12/29/2008

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Directions to “THE ARC OF NORTHERN VIRGINIA ” Practice Location

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