Healthcare Provider Details

I. General information

NPI: 1124732359
Provider Name (Legal Business Name): EXPERT CARE HOMEHEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2023
Last Update Date: 06/01/2023
Certification Date: 06/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17531 ISLE ROYALE TER
DUMFRIES VA
22025-1979
US

IV. Provider business mailing address

17531 ISLE ROYALE TER
DUMFRIES VA
22025-1979
US

V. Phone/Fax

Practice location:
  • Phone: 571-580-3070
  • Fax: 571-580-3070
Mailing address:
  • Phone: 571-580-3070
  • Fax: 859-297-6774

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 Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: NOOR WAIS WALI
Title or Position: PRESIDENT/DON
Credential: RN
Phone: 703-473-6805