Healthcare Provider Details
I. General information
NPI: 1144924648
Provider Name (Legal Business Name): FRIENDLY HOME HEALTH CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/28/2023
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3536 CARLIN SPRINGS RD
FALLS CHURCH VA
22041-3003
US
IV. Provider business mailing address
3536 CARLIN SPRINGS RD
FALLS CHURCH VA
22041-3003
US
V. Phone/Fax
- Phone: 571-331-7275
- Fax:
- Phone: 571-331-7275
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385H00000X |
| Taxonomy | Respite Care |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARYAN
JAMA
Title or Position: OWNER
Credential:
Phone: 571-331-7275