Healthcare Provider Details

I. General information

NPI: 1912597402
Provider Name (Legal Business Name): AT HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2021
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14143 ROBERT PARIS CT
CHANTILLY VA
20151-4201
US

IV. Provider business mailing address

14143 ROBERT PARIS CT
CHANTILLY VA
20151-4201
US

V. Phone/Fax

Practice location:
  • Phone: 571-351-6045
  • Fax: 571-320-1876
Mailing address:
  • Phone: 571-206-8464
  • Fax: 571-320-1876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HANNAH BEYAN
Title or Position: OWNER
Credential:
Phone: 301-232-8649