MEDICARE: SHALOM LIFE CARE SOLUTION 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1932057676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHALOM LIFE CARE SOLUTION LLC

Provider Business Mailing Address
First Line	:	2121 EISENHOWER AVE STE 218
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-4698
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2121 EISENHOWER AVE STE 218
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22314-4698
Country	:	US
Telephone Number	:	202-560-3558
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MIKE BIOUMLA
Credential	:
Telephone Number	:	202-560-3558

Provider Enumeration Date	:	03/18/2026
Last Update Date	:	03/18/2026

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Directions to “SHALOM LIFE CARE SOLUTION LLC ” Practice Location

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