Healthcare Provider Details

I. General information

NPI: 1245170190
Provider Name (Legal Business Name): CENTER OF CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13550 HEATHCOTE BLVD APT 355
GAINESVILLE VA
20155-6688
US

IV. Provider business mailing address

10391 DYLAN PL
MANASSAS VA
20109-6400
US

V. Phone/Fax

Practice location:
  • Phone: 812-223-6487
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: FELICIEN I NTABAZA
Title or Position: OWNER
Credential:
Phone: 812-223-6487