COMMONWEALTH OF VIRGINIA DEPT OF MENTAL HEALTH AND NORTHERN VIRGINIA T (NPI# 1053347476) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053347476 |
| Entity Type | Organization |
| Organization Name | COMMONWEALTH OF VIRGINIA DEPT OF MENTAL HEALTH AND NORTHERN VIRGINIA T |
| Practice Address |
9901 Braddock Rd Fairfax VA 22032-1904 |
| Practice Telephone | 7033234000 |
| Practice Fax Number | 7033234252 |
| Mailing Telephone | 7033234000 |
| Mailing Fax Number | 7033234252 |
| Enumeration Date | 2006-06-25 |
| Last Update Date | 2008-06-19 |
| Authorized Official Name | DR. MARK S DIORIO (FACILITY DIRECTOR) |
| Authorized Official Telephone | 7033234002 |
| Authorized Official Credential | PH.D., MPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208M00000X | Hospitalist | Allopathic & Osteopathic Physicians | ||
| N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities | ||
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 49-6630-9 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811171309 | Commonwealth of Virginia Dept of Mental Health and Northern Virginia T | Pediatrics | 9901 Braddock Rd, Fairfax, VA 22032-1904 | 2007-12-20 |
| Street Address |
9901 BRADDOCK RD |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22032-1904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275530941 | Joseph Michael Caturano Sr. | Pharmacist | 9901 Braddock Rd, Fairfax, VA 22032-1904 | 2005-07-07 |
| 1972998698 | Yue-ling Du | Speech-Language Pathologist | 9901 Braddock Rd, Fairfax, VA 22032-1904 | 2015-03-31 |
| 1811171309 | Commonwealth of Virginia Dept of Mental Health and Northern Virginia T | Pediatrics | 9901 Braddock Rd, Fairfax, VA 22032-1904 | 2007-12-20 |
| 1790966935 | Paul Franklin Anders IIi | Psychologist | 9901 Braddock Rd, Fairfax, VA 22032-1904 | 2007-11-15 |
| 1336207554 | Dongsup Kim | Dentist | 9901 Braddock Rd, Fairfax, VA 22032-1904 | 2006-12-04 |
| 1841367273 | Samer G Jarwa | Dentist | 9901 Braddock Rd, Fairfax, VA 22032 | 2006-11-29 |
| 1568478394 | Maria Fe P Paraguya | Pediatrics | 9901 Braddock Rd, Fairfax, VA 22032-1904 | 2006-08-01 |
| 1558378067 | Michael Sherer | Psychiatry & Neurology | 9901 Braddock Rd, Fairfax, VA 22032-1904 | 2006-08-01 |
| 1699774281 | Lee Ann Peyton | Pharmacist | 9901 Braddock Rd, Fairfax, VA 22032-1904 | 2005-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093193567 | Cynthia Leigh Pascal | Counselor | 9801 Joyce Street, Fairfax, VA 22032 | 2015-05-15 |
| 1760888432 | Judy Lim | Massage Therapist | 4205 Olley Ln, Fairfax, VA 22032 | 2014-11-07 |
| 1083015010 | Caring Heart Nursing Services LLC | Registered Nurse | 4824 Gainsborough Dr, Fairfax, VA 22032 | 2014-09-09 |
| 1033483839 | Inovacares for Seniors | PACE Provider Organization | 4027b Olley Lane, Braddock Glen, Fairfax, VA 22032 | 2012-02-27 |
| 1598032716 | Joshua Michael Prozeralik | Pharmacist | 10310 New Guinea Road, Burke, VA 22032 | 2011-11-17 |
| 1356570071 | Azmy A. Iskander | Emergency Medicine | 10520 Acacia Lane, Fairfax, VA 22032 | 2009-07-02 |
| 1851515175 | The Pediatric Group, PC | Registered Nurse | 10527 Braddock Road, Fairfax, VA 22032 | 2007-04-11 |
| 1770634313 | Andrea L Lubeck | Nurse Practitioner | 10301 New Guinea Road, Cvs Health, Minuteclinic, Fairfax, VA 22032 | 2007-01-12 |
| 1104167212 | Inova Health Care Services | PACE Provider Organization | 4027b Olley Lane, Braddock Glen, Fairfax, VA 22032 | 2013-03-14 |
| 1770835993 | Catherine A Groden | Nurse Practitioner | 10301 New Guinea Rd, Target, Fairfax, VA 22032 | 2012-10-11 |
| Find all providers in zip 22032 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598381758 | Mount Rogers Community Services | Intermediate Care Facility, Mentally Retarded | 56 Carroll House Ln, Hillsville, VA 24343-3648 | 2020-06-23 |
| 1871123729 | Mount Rogers Community Services | Intermediate Care Facility, Mentally Retarded | 795 Fairview Rd, Wytheville, VA 24382-4501 | 2020-01-20 |
| 1194379529 | Dignity Care Inc | Intermediate Care Facility, Mentally Retarded | 16654 Bolling Brook Ct, Woodbridge, VA 22191-4583 | 2019-07-24 |
| 1821657719 | Hampton-newport News Community Services Board | Intermediate Care Facility, Mentally Retarded | 1421 Aberdeen Rd, Hampton, VA 23666-4027 | 2019-06-13 |
| 1962069054 | Sunny Haven Residental Services | Intermediate Care Facility, Mentally Retarded | 114 Collinswood Dr, Staunton, VA 24401-1988 | 2019-05-23 |
| 1376042523 | Danville Pittsylvania Community Services | Intermediate Care Facility, Mentally Retarded | 505 Keen St, Danville, VA 24540-4657 | 2018-02-02 |
| 1588021596 | Future Alliance LLC | Intermediate Care Facility, Mentally Retarded | 6010 N Crestwood Ave, Suite C, Richmond, VA 23230-2200 | 2016-01-21 |
| 1780052217 | Danville-pittsylvania Community Services | Intermediate Care Facility, Mentally Retarded | 4769 Franklin Tpke, Danville, VA 24540-7807 | 2015-09-15 |
| 1922415934 | Community Residences, Inc. | Intermediate Care Facility, Mentally Retarded | 9332 Burke Rd, Burke, VA 22015-3373 | 2014-07-22 |
| 1891105607 | Horizon Behavioral Health | Intermediate Care Facility, Mentally Retarded | 101 Avoca Ln, Altavista, VA 24517-1154 | 2014-05-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.