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General NPI Number Information
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NPI Number | 1144902453
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Entity Type | Organization
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Legal Business Name | ARDENT HEALTHCARE SERVICES LLC
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Dates
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Enumeration Date | 08/04/2023
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 202 MARIANNE PL
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City | STAFFORD
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State | VA
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Zip | 22554-1621
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Country | US
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Telephone | 571-275-0132
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Fax |
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Provider Business Mailing Address
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Address Line | 202 MARIANNE PL
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City | STAFFORD
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State | VA
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Zip | 22554-1621
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Country | US
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Telephone | 571-275-0132
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/CEO
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Name | KHADIJA MACAULLY
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Credential | NP
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Telephone | 571-275-0132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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