Healthcare Provider Details

I. General information

NPI: 1497617856
Provider Name (Legal Business Name): LIBERTY HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1376 OLD BRIDGE RD STE 101-4
WOODBRIDGE VA
22192-2762
US

IV. Provider business mailing address

1376 OLD BRIDGE RD
WOODBRIDGE VA
22192-2762
US

V. Phone/Fax

Practice location:
  • Phone: 571-455-1700
  • Fax: 571-366-2770
Mailing address:
  • Phone: 571-455-1700
  • Fax: 571-366-2770

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 Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MORSHED ALAM
Title or Position: CHAIRMAN
Credential:
Phone: 571-455-1700