Healthcare Provider Details

I. General information

NPI: 1871329813
Provider Name (Legal Business Name): DYNAMIC CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2024
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4229 LAFAYETTE CENTER DR STE 1300
CHANTILLY VA
20151-1260
US

IV. Provider business mailing address

4229 LAFAYETTE CENTER DR STE 1300
CHANTILLY VA
20151-1260
US

V. Phone/Fax

Practice location:
  • Phone: 571-510-2011
  • Fax:
Mailing address:
  • Phone: 571-510-2011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MUSTAFA TAHEERI
Title or Position: CEO
Credential:
Phone: 571-510-2011