Healthcare Provider Details

I. General information

NPI: 1811556558
Provider Name (Legal Business Name): PASSION HOME HEALTH SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2019
Last Update Date: 01/14/2022
Certification Date: 01/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1880 HOWARD AVE STE 307
VIENNA VA
22182-2631
US

IV. Provider business mailing address

1880 HOWARD AVE STE 307
VIENNA VA
22182-2631
US

V. Phone/Fax

Practice location:
  • Phone: 703-462-9141
  • Fax: 703-462-9142
Mailing address:
  • Phone: 703-462-9141
  • Fax: 703-462-9142

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: MISS EUNICE J SOKA
Title or Position: ADIMINSTRATOR
Credential:
Phone: 703-462-9141