Healthcare Provider Details

I. General information

NPI: 1790505139
Provider Name (Legal Business Name): AT INTOUCH HOME CARE AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2024
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5290 SHAWNEE RD STE 2O0 OFFICE 16B
ALEXANDRIA VA
22312
US

IV. Provider business mailing address

7714 ARLEN ST
ANNANDALE VA
22003-5404
US

V. Phone/Fax

Practice location:
  • Phone: 571-682-9362
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: ASCHALEW TAKELE
Title or Position: MANAGER
Credential:
Phone: 571-682-9362