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General NPI Number Information
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NPI Number | 1134356082
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Entity Type | Organization
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Legal Business Name | HOME CARE PROVIDERS LLC
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Dates
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Enumeration Date | 06/18/2009
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Last Update Date | 10/02/2009
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Provider Practice Location Address
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Address Line | 5881 LEESBURG PIKE SUITE 504
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City | FALLS CHURCH
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State | VA
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Zip | 22041-2314
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Country | US
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Telephone | 703-998-4080
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Fax | 703-998-4081
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Provider Business Mailing Address
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Address Line | 5881 LEESBURG PIKE SUITE 504
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City | FALLS CHURCH
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State | VA
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Zip | 22041-2314
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Country | US
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Telephone | 703-998-4080
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Fax | 703-998-4081
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | WONDWOSSEN HAILE
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Credential |
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Telephone | 703-585-0738
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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 | T005944
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License Number State | VA
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