Healthcare Provider Details

I. General information

NPI: 1912580440
Provider Name (Legal Business Name): EPIC HOME HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2021
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1875 CAMPUS COMMONS DR STE 210
RESTON VA
20191-1567
US

IV. Provider business mailing address

3201 ORIENT FISHTAIL RD
LAUREL MD
20724-2931
US

V. Phone/Fax

Practice location:
  • Phone: 240-426-6988
  • Fax:
Mailing address:
  • Phone: 240-426-6988
  • Fax:

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 Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MUNDE MBAYO
Title or Position: ADMINISTRATOR
Credential:
Phone: 571-249-5819