Healthcare Provider Details

I. General information

NPI: 1386469906
Provider Name (Legal Business Name): WE CARE HOME HEALTH AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2024
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1765 GREENSBORO STATION PL FL 9
MC LEAN VA
22102-3472
US

IV. Provider business mailing address

1765 GREENSBORO STATION PL FL 9
MC LEAN VA
22102-3472
US

V. Phone/Fax

Practice location:
  • Phone: 703-574-0669
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. QUIANA WAGNER
Title or Position: OWNER
Credential:
Phone: 404-275-1579