Healthcare Provider Details

I. General information

NPI: 1639482318
Provider Name (Legal Business Name): STANDARD HEALTHCARE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2010
Last Update Date: 07/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1073 W BROAD ST SUITE 201
FALLS CHURCH VA
22046-4612
US

IV. Provider business mailing address

20942 DURYEA TER
ASHBURN VA
20147-6494
US

V. Phone/Fax

Practice location:
  • Phone: 703-676-7720
  • Fax: 703-891-1789
Mailing address:
  • Phone: 703-675-7720
  • Fax: 703-891-1789

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHCO-10252
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberHCO-10252
License Number StateVA

VIII. Authorized Official

Name: MS. ISIBOR JOY NOSEGBE
Title or Position: EXECUTIVE DIRECTOR
Credential: R.N.
Phone: 703-675-7720