Healthcare Provider Details

I. General information

NPI: 1023627452
Provider Name (Legal Business Name): ELYON HOME HEALTHCARE, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2020
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18139 TRIANGLE SHOPPING PLZ STE 213
DUMFRIES VA
22026-2582
US

IV. Provider business mailing address

18139 TRIANGLE SHOPPING PLZ STE 213
DUMFRIES VA
22026-2582
US

V. Phone/Fax

Practice location:
  • Phone: 703-986-0161
  • Fax: 703-986-0717
Mailing address:
  • Phone: 703-986-0161
  • Fax: 703-986-0717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KENNETH KWEKU BANSAH
Title or Position: OWNER
Credential:
Phone: 703-986-0161