Healthcare Provider Details

I. General information

NPI: 1780194548
Provider Name (Legal Business Name): VIE HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2017
Last Update Date: 10/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44330 MERCURE CIR STE 100V
STERLING VA
20166-2023
US

IV. Provider business mailing address

44330 MERCURE CIR STE 100V
STERLING VA
20166-2023
US

V. Phone/Fax

Practice location:
  • Phone: 703-949-0986
  • Fax:
Mailing address:
  • Phone: 703-949-0986
  • 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 Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: VIVIANE YIMGA NGASSAM
Title or Position: OWNER
Credential:
Phone: 703-949-0986