Healthcare Provider Details

I. General information

NPI: 1780469288
Provider Name (Legal Business Name): CENTRIXCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2023
Last Update Date: 08/31/2023
Certification Date: 08/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

722 E MARKET ST STE 102 OFC A37
LEESBURG VA
20176-4475
US

IV. Provider business mailing address

722 E MARKET ST STE 102
LEESBURG VA
20176-4475
US

V. Phone/Fax

Practice location:
  • Phone: 571-479-7991
  • Fax:
Mailing address:
  • Phone: 571-479-7991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: NAIMA ABDI
Title or Position: OWNER/CEO
Credential:
Phone: 571-233-2093