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General NPI Number Information
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NPI Number | 1194901694
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Entity Type | Organization
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Legal Business Name | HOME HEALTH CONNECT
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Dates
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Enumeration Date | 01/14/2008
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Last Update Date | 01/14/2008
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Provider Practice Location Address
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Address Line | 6969 RICHMOND HWY #101
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City | ALEXANDRIA
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State | VA
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Zip | 22306-1839
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Country | US
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Telephone | 703-768-7351
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Fax | 703-768-7832
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Provider Business Mailing Address
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Address Line | 6969 RICHMOND HWY #101
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City | ALEXANDRIA
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State | VA
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Zip | 22306-1839
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Country | US
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Telephone | 703-768-7351
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Fax | 703-768-7832
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT
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Name | MRS. TEMI O BODUNRIN
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Credential |
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Telephone | 443-226-5814
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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-08278
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License Number State | VA
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