Healthcare Provider Details

I. General information

NPI: 1346946555
Provider Name (Legal Business Name): MEHR HOME CARE AGENCY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2023
Last Update Date: 01/31/2023
Certification Date: 01/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1875 CAMPUS COMMONS DRIVE SUITE 210 OFFICE 7
RESTON VA
20191
US

IV. Provider business mailing address

1875 CAMPUS COMMONS DRIVE SUITE 210 OFFICE 7
RESTON VA
20191
US

V. Phone/Fax

Practice location:
  • Phone: 571-206-8057
  • Fax: 703-935-2170
Mailing address:
  • Phone: 571-206-8057
  • Fax: 703-935-2170

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: ALI MAHBOUBI
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 571-271-8207