Provider Demographics
NPI:1447619994
Name:GERIATRICARE MANAGEMENT, INC.
Entity type:Organization
Organization Name:GERIATRICARE MANAGEMENT, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:IONEDES
Authorized Official - Last Name:THOMOPOULOS
Authorized Official - Suffix:
Authorized Official - Credentials:BCD
Authorized Official - Phone:703-313-6114
Mailing Address - Street 1:6422 GROVEDALE DRIVE
Mailing Address - Street 2:202
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-2534
Mailing Address - Country:US
Mailing Address - Phone:703-313-6114
Mailing Address - Fax:
Practice Address - Street 1:6422 GROVEDALE DR
Practice Address - Street 2:202
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-2570
Practice Address - Country:US
Practice Address - Phone:703-313-6114
Practice Address - Fax:703-313-7815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-12
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO16363251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health