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General NPI Number Information
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NPI Number | 1053742387
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Entity Type | Organization
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Legal Business Name | HERITAGE HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 12/12/2013
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Last Update Date | 12/12/2013
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Provider Practice Location Address
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Address Line | 1940 DUKE ST SUITE 200
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City | ALEXANDRIA
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State | VA
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Zip | 22314-3451
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Country | US
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Telephone | 571-294-1410
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Fax |
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Provider Business Mailing Address
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Address Line | 1940 DUKE ST SUITE 200
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City | ALEXANDRIA
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State | VA
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Zip | 22314-3451
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LENSA ERENNA
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Credential |
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Telephone | 703-409-2990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | HCO-141019
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License Number State | VA
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