Healthcare Provider Details

I. General information

NPI: 1659732907
Provider Name (Legal Business Name): SPRING HOME CARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2016
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6924 LITTLE RIVER TPKE STE C
ANNANDALE VA
22003-3292
US

IV. Provider business mailing address

6924 LITTLE RIVER TPKE STE C
ANNANDALE VA
22003-3292
US

V. Phone/Fax

Practice location:
  • Phone: 703-642-1000
  • Fax:
Mailing address:
  • Phone: 703-642-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number1559586
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. SHAKIBA HAKAMI
Title or Position: OWNER
Credential:
Phone: 703-642-1000