Healthcare Provider Details

I. General information

NPI: 1245613363
Provider Name (Legal Business Name): PARAGON HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2015
Last Update Date: 07/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 CHAIN BRIDGE RD SUITE 136
MC LEAN VA
22101-4451
US

IV. Provider business mailing address

1515 CHAIN BRIDGE RD SUITE 136
MC LEAN VA
22101-4451
US

V. Phone/Fax

Practice location:
  • Phone: 703-942-8950
  • Fax: 703-552-1345
Mailing address:
  • Phone: 703-942-8950
  • Fax: 703-552-1345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHCO-151029
License Number StateVA

VIII. Authorized Official

Name: MR. JUAN TUASON
Title or Position: PRESIDENT/CO-OWNER
Credential: MBA
Phone: 703-942-8950