NPI 1780102335

Illuminated Direction

Organisation Health Maintenance Organization Springfield, VA

Practice location

Address: 6116 Rolling Road Suite 104, Springfield, VA 22152
Phone: (571) 730-8445
Fax: (888) 227-5443

Authorised official

Name: Jonathan Lacewell
Title: Owner
Phone: (919) 452-7931

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X

Other Health Maintenance Organization providers in Virginia →

Registry record

NPI: 1780102335
Entity type: Organization
NPI issued: 5 Sep 2017
Record last updated: 5 Sep 2017

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.