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General NPI Number Information
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NPI Number | 1174708291
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Entity Type | Organization
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Legal Business Name | BEATRIZ ELDERLY CARE
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Dates
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Enumeration Date | 01/08/2008
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Last Update Date | 01/08/2008
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Provider Practice Location Address
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Address Line | 4101 CHAIN BRIDGE RD STE 308
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City | FAIRFAX
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State | VA
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Zip | 22030-4105
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Country | US
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Telephone | 703-344-1022
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Fax |
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Provider Business Mailing Address
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Address Line | 4101 CHAIN BRIDGE RD STE 308
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City | FAIRFAX
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State | VA
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Zip | 22030-4105
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Country | US
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Telephone | 703-344-1022
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. VANESSA GISELLE AZANEDO
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Credential |
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Telephone | 703-344-1022
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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 | HCO-08462
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License Number State | VA
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