Healthcare Provider Details

I. General information

NPI: 1932059656
Provider Name (Legal Business Name): HOME SWEET HOME CHILDCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15064 CARROLLTON BLVD STE 9
CARROLLTON VA
23314-3580
US

IV. Provider business mailing address

15064 CARROLLTON BLVD STE 9
CARROLLTON VA
23314-3580
US

V. Phone/Fax

Practice location:
  • Phone: 757-401-2504
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: BREANN ELLIS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MSW, CSAC
Phone: 757-401-2504