Healthcare Provider Details

I. General information

NPI: 1164722237
Provider Name (Legal Business Name): YOUNGS HEALTHCARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2010
Last Update Date: 08/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7018 EVERGREEN CT STE 5A
ANNANDALE VA
22003-3271
US

IV. Provider business mailing address

4215 EVERGREEN LN
ANNANDALE VA
22003-3210
US

V. Phone/Fax

Practice location:
  • Phone: 703-649-4271
  • Fax: 877-628-2718
Mailing address:
  • Phone: 703-649-4271
  • Fax: 877-628-2718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License NumberHCO-11695
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberHCO-11695
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHCO-11695
License Number StateVA

VIII. Authorized Official

Name: MRS. YOUNG SHIN LEE
Title or Position: ADMINISTRATOR
Credential:
Phone: 703-628-2175