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General NPI Number Information
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NPI Number | 1205358561
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Entity Type | Organization
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Legal Business Name | TRUSTHAVEN HOMECARE
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Dates
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Enumeration Date | 07/07/2017
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Last Update Date | 07/07/2017
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Provider Practice Location Address
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Address Line | 8809 SUDLEY RD STE 221
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City | MANASSAS
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State | VA
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Zip | 20110-4749
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Country | US
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Telephone | 412-641-9009
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Fax |
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Provider Business Mailing Address
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Address Line | 15704 JOHN DISKIN CIR
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City | WOODBRIDGE
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State | VA
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Zip | 22191-6555
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Country | US
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Telephone | 412-641-9009
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF NURSING
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Name | CHIZOBA MUOKA
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Credential | RN
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Telephone | 412-641-9009
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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 |
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License Number State |
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