Healthcare Provider Details

I. General information

NPI: 1427838135
Provider Name (Legal Business Name): FOREVER FAMILY HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2023
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 LEESBURG PIKE STE 405
ALEXANDRIA VA
22302-1108
US

IV. Provider business mailing address

4900 LEESBURG PIKE STE 405
ALEXANDRIA VA
22302-1108
US

V. Phone/Fax

Practice location:
  • Phone: 571-489-4589
  • Fax:
Mailing address:
  • Phone:
  • 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
# 3
Primary TaxonomyN
Taxonomy Code385HR2050X
TaxonomyRespite Care Camp
License Number
License Number State

VIII. Authorized Official

Name: RUQIO WEYRAH
Title or Position: ADMIN
Credential:
Phone: 571-275-0458