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General NPI Number Information
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NPI Number | 1073197604
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Entity Type | Organization
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Legal Business Name | STALWART HOME HEALTH LLC
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Dates
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Enumeration Date | 05/10/2021
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Last Update Date | 05/10/2021
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Provider Practice Location Address
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Address Line | 13000 HARBOR CENTER DR # 312M
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City | WOODBRIDGE
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State | VA
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Zip | 22192-2846
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Country | US
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Telephone | 571-466-8794
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Fax |
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Provider Business Mailing Address
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Address Line | 2004 PIN OAK PKWY
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City | BOWIE
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State | MD
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Zip | 20721-3098
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Country | US
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Telephone | 301-346-3640
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MATILDA CHE
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Credential |
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Telephone | 301-346-3640
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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 |
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License Number State |
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