Provider Demographics
NPI:1861999245
Name:SZR ALEXANDRIA ASSISTED LIVING, LP
Entity type:Organization
Organization Name:SZR ALEXANDRIA ASSISTED LIVING, LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-212-9192
Mailing Address - Street 1:3520 DUKE ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-6303
Mailing Address - Country:US
Mailing Address - Phone:703-212-9192
Mailing Address - Fax:703-370-1592
Practice Address - Street 1:3520 DUKE ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-6303
Practice Address - Country:US
Practice Address - Phone:703-212-9192
Practice Address - Fax:703-370-1592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-11
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAALF1103939-L155310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility