Woodbridge SH Lessee, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

WOODBRIDGE SH LESSEE, LLC

Practice address

14080 Central Loop
Woodbridge, VA 22193-1438

Phone

(703) 721-8801

Fax

(571) 285-2274

NPI assigned

Apr 23, 2019

Organization subpart

Yes

Parent organization

WOODBRIDGE SH LESSEE, LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Susan L Haynes

Title

Executive Director

Phone

(703) 721-8801

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• HarborChase of Prince William Commons Doing business as
• Arbor Terrace Prince William Commons Other name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Woodbridge SH Lessee LLC

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675900800000",
    "number": "1659935880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14080 CENTRAL LOOP",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "22193",
            "telephone_number": "703-721-8801",
            "fax_number": "571-285-2274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14080 CENTRAL LOOP",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221931438",
            "telephone_number": "703-721-8801",
            "fax_number": "571-285-2274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODBRIDGE SH LESSEE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WOODBRIDGE SH LESSEE, LLC",
        "enumeration_date": "2019-04-23",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A",
        "authorized_official_last_name": "HAYNES",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "703-721-8801"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASSISTED LIVING AND MEMORY CARE",
            "identifier": "ALF1105083",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HarborChase of Prince William Commons",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Arbor Terrace Prince William Commons",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Woodside Healthcare

• Assisted Living Facility in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Assisted Living Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.