Individual provider · Type 1 NPI
Derrick John Mathis, ALFA
Nursing Home Administrator · Manassas, VA
NPI number
1780822841
Active
Practice location
9827 Sudley Manor Dr
Manassas, VA 20109-6232
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nursing Home Administrator Primary | 376G00000X | 1706000192 (VA) |
Nursing Home Administrator: An individual, often licensed by the state, who is responsible for the management of a nursing home.
About NPI 1780822841
Derrick John Mathis, ALFA's National Provider Identifier is 1780822841, issued on Jan 28, 2009. The primary taxonomy on file is Nursing Home Administrator (376G00000X), and the practice location is in Manassas, VA. The record was last updated on Jan 28, 2009.