=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104600436
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GREENHILL HOME CARE SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/18/2023
-----------------------------------------------------
Last Update Date | 12/26/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13954 ANTONIA FORD CT
-----------------------------------------------------
City | CENTREVILLE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 20121-3568
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-279-6588
-----------------------------------------------------
Fax | 703-279-6578
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1050 CONNECTICUT AVE NW STE 500
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20036-5304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-459-7682
-----------------------------------------------------
Fax | 703-279-6578
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR/CEO
-----------------------------------------------------
Name | MS. GISELE ONGA NANA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 703-459-7682
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 385H00000X
-----------------------------------------------------
Taxonomy Name | Respite Care
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 385HR2065X
-----------------------------------------------------
Taxonomy Name | Child Physical Disabilities Respite Care
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------