Healthcare Provider Details

I. General information

NPI: 1174405419
Provider Name (Legal Business Name): WACA AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2025
Last Update Date: 01/27/2026
Certification Date: 01/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 WILSON BLVD STE 700
ARLINGTON VA
22209-2490
US

IV. Provider business mailing address

1550 WILSON BLVD STE 700
ARLINGTON VA
22209-2490
US

V. Phone/Fax

Practice location:
  • Phone: 703-810-0825
  • Fax:
Mailing address:
  • Phone: 571-422-9530
  • Fax:

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: NQOBILE FAITH DUMISA
Title or Position: ADMINISTRATOR
Credential:
Phone: 571-422-9530