Healthcare Provider Details

I. General information

NPI: 1750820387
Provider Name (Legal Business Name): A&B HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2017
Last Update Date: 10/20/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7880 BACKLICK ROAD SUITE 5A
SPRINGFIELD VA
22150
US

IV. Provider business mailing address

7880 BACKLICK ROAD SUITE 5A
SPRINGFIELD VA
22150
US

V. Phone/Fax

Practice location:
  • Phone: 703-899-0392
  • Fax: 703-372-5290
Mailing address:
  • Phone: 703-899-0392
  • Fax: 703-372-5290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHCO-171598
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License NumberHCO-171598
License Number StateVA

VIII. Authorized Official

Name: ADELAIDE DOKUA BOOHENE
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 703-899-0392