Provider Demographics
NPI:1194194761
Name:INOVA HEALTH SYSTEM SERVICES
Entity type:Organization
Organization Name:INOVA HEALTH SYSTEM SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SSHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:YUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-934-5069
Mailing Address - Street 1:4300 GEORGE MASON BLVD
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-4295
Mailing Address - Country:US
Mailing Address - Phone:703-934-5069
Mailing Address - Fax:703-272-4689
Practice Address - Street 1:4300 GEORGE MASON BLVD
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-4295
Practice Address - Country:US
Practice Address - Phone:703-934-5069
Practice Address - Fax:703-272-4689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-24
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA103095310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility