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General NPI Number Information
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NPI Number | 1033579735
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Entity Type | Organization
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Legal Business Name | HOLY HOME HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 02/24/2016
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Last Update Date | 02/24/2016
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Provider Practice Location Address
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Address Line | 8201 GREENSBORO DR SUITE 300
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City | MC LEAN
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State | VA
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Zip | 22102-3810
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Country | US
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Telephone | 703-287-4235
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Fax | 703-995-0934
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Provider Business Mailing Address
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Address Line | 8201 GREENSBORO DR SUITE 300
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City | MC LEAN
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State | VA
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Zip | 22102-3810
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Country | US
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Telephone | 703-287-4235
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Fax | 703-995-0934
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Authorized Official
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Title or Position | CEO
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Name | CELESTIN NIYONGABO
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Credential |
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Telephone | 540-538-2503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HCO-161395
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License Number State | VA
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