CPL Iliff LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH2592 Issued in VA

Legal business name

CPL ILIFF LLC

Doing business as

Iliff Nursing and Rehabilitation Center

Practice address

8000 Iliff Drive
Dunn Loring, VA 22027-1235

Phone

(703) 560-1000

Fax

(703) 280-0406

NPI assigned

Nov 4, 2005

Last updated

Jul 27, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Carole M Scillia

Title

LLC Manager

Phone

(203) 608-6100

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Iliff Nursing and Rehabilitation Center Doing business as

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311724800000",
    "number": "1821089194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 PRESTON AVENUE",
            "address_2": "SUITE 270",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064504851",
            "telephone_number": "203-608-6100",
            "fax_number": "203-639-3574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 ILIFF DRIVE",
            "city": "DUNN LORING",
            "state": "VA",
            "postal_code": "220271235",
            "telephone_number": "703-560-1000",
            "fax_number": "703-280-0406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CPL ILIFF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-04",
        "last_updated": "2011-07-27",
        "status": "A",
        "authorized_official_last_name": "SCILLIA",
        "authorized_official_first_name": "CAROLE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "LLC MANAGER",
        "authorized_official_telephone_number": "203-608-6100",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "VA",
            "license": "NH2592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821089194",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004960360",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004952057",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Iliff Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Antara Bansal
• Jennifer Guzi Casolaro, NP
• Jonathan Youngkwon Chang, DDS
• Christine Chen, PTA
• Marche Elaine Covington, LMFT
• Vivian Yvette Dade, COTA/L
• Robert A Duca Jr., D.C.
• Dunn Loring VA Opco LLC (Iliff Nursing and Rehabilitation Center)
• Skeeter Early, COTA/L
• Mahmud R. Elbackush, MD

• Skilled Nursing Facility in Dunn Loring, VA
• Providers in Dunn Loring, VA by specialty
• Skilled Nursing Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.