Healthcare Provider Details

I. General information

NPI: 1417765025
Provider Name (Legal Business Name): MHHC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2024
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6512 BRICK HEARTH CT
ALEXANDRIA VA
22306-3313
US

IV. Provider business mailing address

6512 BRICK HEARTH CT
ALEXANDRIA VA
22306-3313
US

V. Phone/Fax

Practice location:
  • Phone: 804-402-5163
  • Fax:
Mailing address:
  • Phone: 804-402-5163
  • Fax:

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: FIYORI ABDULKADIR
Title or Position: OWNER
Credential:
Phone: 804-402-5163