Healthcare Provider Details

I. General information

NPI: 1366179020
Provider Name (Legal Business Name): 1 TO 1 HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2022
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10805 MAIN ST STE 800
FAIRFAX VA
22030-4729
US

IV. Provider business mailing address

6033 CALLAWAY CT
CENTREVILLE VA
20121-4684
US

V. Phone/Fax

Practice location:
  • Phone: 703-798-4979
  • Fax: 703-229-1472
Mailing address:
  • Phone: 703-798-4979
  • Fax: 703-229-1472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ABDIRASHID AHMED
Title or Position: PRESIDENT
Credential:
Phone: 703-798-4979