Blackstone Mary Ivy Healthcare LLC

NPI #1982469540 in Lorton, Virginia

Provider Information

NPI Number: 1982469540
Entity Type: Organization
Organization Name: Blackstone Mary Ivy Healthcare LLC
Primary Specialty: Home Health
Enumeration Date: Feb 13, 2024
Last Updated: Feb 13, 2024

Practice Location

Address: 8951 BIRCH BAY CIR
City: Lorton
State: Virginia
ZIP Code: 22079-5660
Phone: (571) 234-3699

Authorized Official

Name: ATO K SMITH-MENSAH
Title: ADMINISTRATOR
Phone: (571) 234-3699

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Home Health	251E00000X	Primary

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