Healthcare Provider Details

I. General information

NPI: 1043961659
Provider Name (Legal Business Name): FIRST HOPE HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

13885 HEDGEWOOD DR STE 337
WOODBRIDGE VA
22193-7932
US

IV. Provider business mailing address

13885 HEDGEWOOD DR STE 337
WOODBRIDGE VA
22193-7932
US

V. Phone/Fax

Practice location:
  • Phone: 703-675-3316
  • Fax:
Mailing address:
  • Phone: 703-675-3316
  • 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 Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MR. RASHAD W LILLY
Title or Position: ADMINISTRATOR
Credential: LPN
Phone: 757-706-1208