FAIRFAX FALLS CHURCH COMMUNITY SERVICE BOARD NPI 1104161736

NPI Information

NPI: 1104161736
Provider Name: FAIRFAX FALLS CHURCH COMMUNITY SERVICE BOARD
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
4213 WALNEY RD
CHANTILLY, VA
ZIP 20151
Phone: (703) 502-7000
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FAIRFAX FALLS CHURCH COMMUNITY SERVICE BOARD is a substance abuse rehabilitation facility in Chantilly, VA. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. FAIRFAX FALLS CHURCH COMMUNITY SERVICE BOARD NPI is 1104161736. The provider is registered as an organization entity type.

The provider's business location address is:

4213 WALNEY RD
CHANTILLY, VA
ZIP 20151-923
Phone: (703) 502-7000

The provider's authorized official is Rosaline Nankam .
The authorized official title is Rn/ Supervisor and has the following contact phone number (703) 502-7005.

The enumeration date for this NPI number is 12/8/2012 and was last updated on 12/8/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	324500000X	Substance Abuse Rehabilitation Facility		0002052809	VIRGINIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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