MEDICARE: PASSION HOME HEALTH SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	HCO-171303	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922404342
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PASSION HOME HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	7918 JONES BRANCH DRIVE, SUITE 451
Second Line	:
City	:	MCLEAN
State	:	VA
Zip	:	22102-2210
Country	:	US
Telephone Number	:	703-752-6128
Fax Number	:	571-300-7660

Provider Business Practice Location Address
First Line	:	7918 JONES BRANCH DR STE 451
Second Line	:
City	:	MC LEAN
State	:	VA
Zip	:	22102-3337
Country	:	US
Telephone Number	:	703-752-6128
Fax Number	:	571-300-7660

Authorized Official
Title or Position	:	OWNER
Name	:	MARIE FOFANAH-CONTEH
Credential	:
Telephone Number	:	703-825-0360

Provider Enumeration Date	:	11/12/2014
Last Update Date	:	10/11/2023

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Directions to “PASSION HOME HEALTH SERVICES LLC ” Practice Location

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