Provider Demographics
NPI:1154889715
Name:WINFIELD MOUNT HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:WINFIELD MOUNT HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:NJOUNKWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-486-2347
Mailing Address - Street 1:4105 MASON RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-2035
Mailing Address - Country:US
Mailing Address - Phone:703-941-4083
Mailing Address - Fax:703-941-4083
Practice Address - Street 1:4105 MASON RIDGE DR
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-2035
Practice Address - Country:US
Practice Address - Phone:703-941-4083
Practice Address - Fax:703-941-4083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-03
Last Update Date:2019-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services