Healthcare Provider Details

I. General information

NPI: 1649806910
Provider Name (Legal Business Name): AFFINITY HOME HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2020
Last Update Date: 03/19/2020
Certification Date: 03/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6273 FRANCONIA RD UNIT 2
ALEXANDRIA VA
22310-2510
US

IV. Provider business mailing address

9021 GILTINAN CT
SPRINGFIELD VA
22153-1113
US

V. Phone/Fax

Practice location:
  • Phone: 571-287-9059
  • 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

VIII. Authorized Official

Name: SOLEMAN SUHAIL
Title or Position: ADMINISTRATOR
Credential:
Phone: 571-287-9059