Funk, Darryl Glen
Funk, Darryl Glen is an sole proprietor health care provider with primary practice located at 521 N Quincy St , Arlington VA 22203-2136. He recently has only one registered license in Residential Treatment Facilities / Substance Abuse Rehabilitation Facility, which is considered as his primary health care specialty. Funk, Darryl Glen can be contacted via phone (703) 841-0703.Contact Information
Primary practice address
521 N Quincy St
Arlington VA 22203-2136
Phone: (703) 841-0703
Fax: (703) 841-2316
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility | 324500000X | 0718000027 | Virginia |
Residential Treatment Facilities / Substance Abuse Rehabilitation Facility | 324500000X | Virginia |
Profile Details
NPI number | 1568612679 |
---|---|
LBN Legal business name | Funk, Darryl Glen |
Credentials | LSATP |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Sep 25th, 2008 |
Last updated | Sep 25th, 2008 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1568612679 | NPPES |
Virginia | MEDICAID | 1558415968 |
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