Healthcare Provider Details

I. General information

NPI: 1689060469
Provider Name (Legal Business Name): DIGNITY-CARE HOME HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2015
Last Update Date: 02/26/2024
Certification Date: 02/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7630 LITTLE RIVER TURN PIKE, ANNANDALE II SUITE 316
ANNANDALE VA
22003
US

IV. Provider business mailing address

9645 FRANKLIN WOODS PL
LORTON VA
22079-2344
US

V. Phone/Fax

Practice location:
  • Phone: 571-347-7361
  • Fax: 571-347-7637
Mailing address:
  • Phone: 703-459-5645
  • Fax: 703-372-2122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberHCO151258
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHCO151258
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License NumberHCO151258
License Number StateVA
# 5
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberHCO151258
License Number StateVA
# 6
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 8
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 9
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: RABIATU BANGURA
Title or Position: PRESIDENT
Credential:
Phone: 703-459-5645