Healthcare Provider Details

I. General information

NPI: 1164844478
Provider Name (Legal Business Name): A PLUS TLC HOME HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2014
Last Update Date: 01/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8989 COTSWOLD DR SUITE #2
BURKE VA
22015-1655
US

IV. Provider business mailing address

6484 OHARA CT. DR.
SPRINGFIELD VA
22152
US

V. Phone/Fax

Practice location:
  • Phone: 703-425-1644
  • Fax: 703-425-1844
Mailing address:
  • Phone: 407-920-8685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRISTIAN BAUTISTA ALFONZO
Title or Position: OFFICE ADMINISTRATOR
Credential:
Phone: 703-425-1644