Healthcare Provider Details

I. General information

NPI: 1508665985
Provider Name (Legal Business Name): KAYIRA HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1376 OLD BRIDGE RD STE 102
WOODBRIDGE VA
22192-2766
US

IV. Provider business mailing address

1376 OLD BRIDGE RD STE 102
WOODBRIDGE VA
22192-2766
US

V. Phone/Fax

Practice location:
  • Phone: 202-207-4885
  • Fax:
Mailing address:
  • Phone: 202-207-4885
  • 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 Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385HR2050X
TaxonomyRespite Care Camp
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: YOUSSOUF KOUYATE
Title or Position: OWNER
Credential:
Phone: 202-207-4885