Healthcare Provider Details

I. General information

NPI: 1851285290
Provider Name (Legal Business Name): MORNINGSIDE HOME HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4949 MANITOBA DR APT 817
ALEXANDRIA VA
22312-4940
US

IV. Provider business mailing address

4949 MANITOBA DR APT 817
ALEXANDRIA VA
22312-4940
US

V. Phone/Fax

Practice location:
  • Phone: 507-358-8276
  • Fax:
Mailing address:
  • Phone: 507-358-8276
  • 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 Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MS. FARDOSA ELMI AHMED
Title or Position: ADMINSTRATION
Credential:
Phone: 703-868-1920