Healthcare Provider Details

I. General information

NPI: 1992273635
Provider Name (Legal Business Name): AAA HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2018
Last Update Date: 09/15/2022
Certification Date: 09/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4609 PINECREST OFFICE PARK DR STE D
ALEXANDRIA VA
22312-1442
US

IV. Provider business mailing address

4609 PINECREST OFFICE PARK DR STE D
ALEXANDRIA VA
22312-1442
US

V. Phone/Fax

Practice location:
  • Phone: 38-273-7577
  • Fax: 703-226-3328
Mailing address:
  • Phone: 703-827-3757
  • Fax: 703-226-3328

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 Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. BRIMA B DEEN
Title or Position: ADMINISTRATOR
Credential: CMBCS
Phone: 571-217-8394