Healthcare Provider Details

I. General information

NPI: 1932708278
Provider Name (Legal Business Name): CARETRUST HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2020
Last Update Date: 04/02/2024
Certification Date: 04/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9020F LORTON STATION BLVD STE 102
LORTON VA
22079-4799
US

IV. Provider business mailing address

9020F LORTON STATION BLVD STE 102
LORTON VA
22079-4799
US

V. Phone/Fax

Practice location:
  • Phone: 571-762-3228
  • Fax: 571-991-2517
Mailing address:
  • Phone: 571-762-3228
  • Fax: 571-991-2517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MARIAMA SESAY
Title or Position: CEO
Credential:
Phone: 571-762-3228