Basic Information
| Provider Information | |||||||||
| NPI: | 1861823114 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NATIONAL REHABILITATION HOSPITAL, INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | MEDSTAR NRH AT LAKE RIDGE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12825 MINNIEVILLE RD | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | WOODBRIDGE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 221923601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7039713701 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 12825 MINNIEVILLE RD | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | WOODBRIDGE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 221923601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7039713701 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2013 | ||||||||
| LastUpdateDate: | 12/11/2013 | ||||||||
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| AuthorizedOfficialLastName: | ZUNIGA | ||||||||
| AuthorizedOfficialFirstName: | PATRICIO | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | AVP | ||||||||
| AuthorizedOfficialTelephone: | 2409653519 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | NATIONAL REHABILITATION HOSPITAL. INC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0400X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation |
No ID Information.