=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013234533
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ELDER OPTIONS SENIOR CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/23/2010
-----------------------------------------------------
Last Update Date | 04/23/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 105 N VIRGINIA AVE SUITE 204
-----------------------------------------------------
City | FALLS CHURCH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22046-3339
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-531-1410
-----------------------------------------------------
Fax | 703-531-1412
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 105 N VIRGINIA AVE SUITE 204
-----------------------------------------------------
City | FALLS CHURCH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22046-3339
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-531-1410
-----------------------------------------------------
Fax | 703-531-1412
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/OWNER
-----------------------------------------------------
Name | MR. SCOTT A ANDREWS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 703-531-1410
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | HCO-10615
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------