Healthcare Provider Details

I. General information

NPI: 1104793983
Provider Name (Legal Business Name): AWRA HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2025
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5420 N MORGAN ST APT 104
ALEXANDRIA VA
22312-3306
US

IV. Provider business mailing address

5420 N MORGAN ST APT 104
ALEXANDRIA VA
22312-3306
US

V. Phone/Fax

Practice location:
  • Phone: 703-939-3503
  • Fax:
Mailing address:
  • Phone: 703-939-3503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: YONAS DITA ELMI
Title or Position: CEO/OWNER
Credential:
Phone: 703-939-3503