Healthcare Provider Details

I. General information

NPI: 1124999255
Provider Name (Legal Business Name): ARDENT HOME HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2025
Last Update Date: 11/27/2025
Certification Date: 11/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 LEESBURG PIKE STE 200D
ALEXANDRIA VA
22302-1000
US

IV. Provider business mailing address

5100 LEESBURG PIKE STE 200D
ALEXANDRIA VA
22302-1000
US

V. Phone/Fax

Practice location:
  • Phone: 703-459-6861
  • Fax: 571-234-6070
Mailing address:
  • Phone: 703-459-6861
  • Fax: 571-234-6070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: WARSAN GULED
Title or Position: ADMINISTRATOR
Credential:
Phone: 703-459-6861