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General NPI Number Information
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NPI Number | 1124410717
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Entity Type | Organization
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Legal Business Name | HOMECARE CREW INC.
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Dates
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Enumeration Date | 02/19/2015
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Last Update Date | 02/19/2015
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Provider Practice Location Address
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Address Line | 22636 GLENN DR SUITE 103
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City | STERLING
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State | VA
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Zip | 20164-4494
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Country | US
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Telephone | 703-935-0956
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 702
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City | STERLING
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State | VA
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Zip | 20167-0702
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Country | US
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Telephone | 703-935-0956
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. HAROON NASRI
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Credential |
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Telephone | 571-282-5638
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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 | HCO151255
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License Number State | VA
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