=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124803408
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KHARIS CARE PARTNERS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/25/2023
-----------------------------------------------------
Last Update Date | 08/29/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 235 GARRISONVILLE RD STE 201
-----------------------------------------------------
City | STAFFORD
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22554-1552
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-634-5185
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 30 CEDAR RIDGE DR APT 200
-----------------------------------------------------
City | STAFFORD
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22554-9419
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-401-6365
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/ADMINISTRATOR
-----------------------------------------------------
Name | MRS. EUGENIA KWA-KOFI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 703-401-6365
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------