Healthcare Provider Details

I. General information

NPI: 1497941785
Provider Name (Legal Business Name): FAMILY HOME HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2007
Last Update Date: 02/01/2024
Certification Date: 02/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5653 COLUMBIA PIKE STE 200
FALLS CHURCH VA
22041-2873
US

IV. Provider business mailing address

5653 COLUMBIA PIKE STE 200
FALLS CHURCH VA
22041-2873
US

V. Phone/Fax

Practice location:
  • Phone: 703-933-2223
  • Fax: 703-933-8887
Mailing address:
  • Phone: 703-933-2223
  • Fax: 703-933-8887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHCO08432
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MS. MAKA AHMED IBRAHIM
Title or Position: ADMINISTRATOR
Credential: C.N.A
Phone: 703-933-2223