Healthcare Provider Details

I. General information

NPI: 1134944614
Provider Name (Legal Business Name): FOREVER SENIOR CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2024
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6521 ARLINGTON BLVD STE 308
FALLS CHURCH VA
22042-3009
US

IV. Provider business mailing address

6521 ARLINGTON BLVD STE 308
FALLS CHURCH VA
22042-3009
US

V. Phone/Fax

Practice location:
  • Phone: 571-723-1833
  • Fax: 703-762-2255
Mailing address:
  • Phone: 571-723-1833
  • Fax: 703-762-2255

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 Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2050X
TaxonomyRespite Care Camp
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385HR2055X
TaxonomyChild Mental Illness Respite Care
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: WILMER MALDONADO
Title or Position: OWNER
Credential:
Phone: 571-423-1833