Healthcare Provider Details

I. General information

NPI: 1144924648
Provider Name (Legal Business Name): FRIENDLY HOME HEALTH CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 LEESBURG PIKE STE B-01
ALEXANDRIA VA
22302-1038
US

IV. Provider business mailing address

5100 LEESBURG PIKE STE B-01
ALEXANDRIA VA
22302-1038
US

V. Phone/Fax

Practice location:
  • Phone: 571-331-7275
  • Fax:
Mailing address:
  • Phone: 571-331-7275
  • Fax: 703-831-2011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARYAN JAMA
Title or Position: OWNER
Credential:
Phone: 571-331-7275