Healthcare Provider Details

I. General information

NPI: 1003650896
Provider Name (Legal Business Name): 1 AAA HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2024
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7432 ALBAN STATION BLVD STE B252
SPRINGFIELD VA
22150-2326
US

IV. Provider business mailing address

7432 ALBAN STATION BLVD STE B252
SPRINGFIELD VA
22150-2326
US

V. Phone/Fax

Practice location:
  • Phone: 202-492-0047
  • Fax: 703-546-5567
Mailing address:
  • Phone: 202-492-0047
  • Fax: 703-546-5567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: OMARFAHDI ABED
Title or Position: OWNER
Credential:
Phone: 202-492-0047