Healthcare Provider Details

I. General information

NPI: 1801202536
Provider Name (Legal Business Name): CARE ADVANTAGE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2014
Last Update Date: 07/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10680 MAIN ST
FAIRFAX VA
22030-3810
US

IV. Provider business mailing address

10041 MIDLOTHIAN TPKE
NORTH CHESTERFIELD VA
23235-4815
US

V. Phone/Fax

Practice location:
  • Phone: 703-436-4767
  • Fax: 703-272-7533
Mailing address:
  • Phone: 804-323-9464
  • Fax: 804-330-3156

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: MS. DEBORAH J JOHNSTON
Title or Position: OWNER
Credential: R.N.
Phone: 804-323-9464