Provider Demographics
NPI:1194690255
Name:VIRGINIA OPEN SENIOR DAY CARE LLC
Entity type:Organization
Organization Name:VIRGINIA OPEN SENIOR DAY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JONGHOON
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:ADULT DAY CARE
Authorized Official - Phone:703-280-0910
Mailing Address - Street 1:8109 LITTLE RIVER TPKE
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-2327
Mailing Address - Country:US
Mailing Address - Phone:703-280-0910
Mailing Address - Fax:571-487-8751
Practice Address - Street 1:5649 MOUNT GILEAD RD
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20120-1906
Practice Address - Country:US
Practice Address - Phone:703-280-0910
Practice Address - Fax:571-487-8751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-08
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care