Healthcare Provider Details

I. General information

NPI: 1477405199
Provider Name (Legal Business Name): FAITH HOME HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2026
Last Update Date: 02/13/2026
Certification Date: 02/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12797 OCCOQUAN RD
WOODBRIDGE VA
22192-2709
US

IV. Provider business mailing address

12797 OCCOQUAN RD
WOODBRIDGE VA
22192-2709
US

V. Phone/Fax

Practice location:
  • Phone: 571-227-0861
  • Fax:
Mailing address:
  • Phone: 571-227-0861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
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: MADINA SAFARI
Title or Position: ALTERNATE ADMINISTRATOR
Credential:
Phone: 571-227-0638