NPI 1104161736

Fairfax Falls Church Community Service Board

Organisation Substance Abuse Rehabilitation Facility Chantilly, VA

Practice location

Address: 4213 Walney Rd, Chantilly, VA 20151-2923
Phone: (703) 502-7000

Authorised official

Name: Rosaline Nankam
Title: RN/ Supervisor
Phone: (703) 502-7005

Registered specialties

Substance Abuse Rehabilitation Facility Primary

Residential Treatment Facilities Taxonomy 324500000X Licence 0002052809 (VA)

Other Substance Abuse Rehabilitation Facility providers in Virginia →

Registry record

NPI: 1104161736
Entity type: Organization
NPI issued: 8 Dec 2012
Record last updated: 8 Dec 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.