Healthcare Provider Details
I. General information
NPI: 1861326977
Provider Name (Legal Business Name): POTENTIALCARE HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3227 COFER RD APT A
RICHMOND VA
23224-6403
US
IV. Provider business mailing address
10304 EATON PL STE 100
FAIRFAX VA
22030-2221
US
V. Phone/Fax
- Phone: 804-928-1119
- Fax:
- Phone: 800-555-0100
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
FRANK
JULIUS
SWAI
Title or Position: CEO
Credential: OWNER
Phone: 804-928-1119