Healthcare Provider Details

I. General information

NPI: 1912412784
Provider Name (Legal Business Name): UNITED HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2017
Last Update Date: 12/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6066 LEESBURG PIKE
FALLS CHURCH VA
22041-2234
US

IV. Provider business mailing address

6066 LEESBURG PIKE STE 845
FALLS CHURCH VA
22041-2234
US

V. Phone/Fax

Practice location:
  • Phone: 571-257-9854
  • Fax:
Mailing address:
  • Phone: 571-257-9854
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHCO-
License Number StateVA

VIII. Authorized Official

Name: MOHAMMAD HARIS
Title or Position: ADMINISTRATOR
Credential:
Phone: 571-499-2392