Pavilion Pace, LLC

NPI #1164310496 in Annandale, Virginia

Provider Information

NPI Number: 1164310496
Entity Type: Organization
Organization Name: Pavilion Pace, LLC
Primary Specialty: Program of All-Inclusive Care for the Elderly (PACE) Provider Organization
Enumeration Date: Jun 25, 2025
Last Updated: Jun 25, 2025

Practice Location

Address: 4115 ANNANDALE RD STE 100
City: Annandale
State: Virginia
ZIP Code: 22003-2583
Phone: (240) 346-7488

Authorized Official

Name: GIBSON ERHUNMWUNSE, DNP
Title: CEO
Phone: (240) 346-7488

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Program of All-Inclusive Care for the Elderly (PACE) Provider Organization	251T00000X	Primary

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