Healthcare Provider Details

I. General information

NPI: 1417771825
Provider Name (Legal Business Name): ASHIYANA HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2024
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16909 CASS BROOK LN
WOODBRIDGE VA
22191-5112
US

IV. Provider business mailing address

16909 CASS BROOK LN
WOODBRIDGE VA
22191-5112
US

V. Phone/Fax

Practice location:
  • Phone: 347-356-8933
  • Fax: 202-598-6405
Mailing address:
  • Phone: 347-356-8933
  • Fax: 202-598-6405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: FALAK KAZMI
Title or Position: ADMINISTRATOR
Credential:
Phone: 347-356-8933