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General NPI Number Information
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NPI Number | 1225899727
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Entity Type | Organization
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Legal Business Name | AMAZING SUPPORTS SERVICES LLC
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Dates
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Enumeration Date | 01/22/2024
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Last Update Date | 01/22/2024
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Provider Practice Location Address
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Address Line | 6911 RICHMOND HWY STE 324B
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City | ALEXANDRIA
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State | VA
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Zip | 22306-1842
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Country | US
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Telephone | 703-509-8778
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Fax |
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Provider Business Mailing Address
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Address Line | 6911 RICHMOND HWY STE 324B
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City | ALEXANDRIA
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State | VA
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Zip | 22306-1842
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Country | US
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Telephone | 703-509-8778
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Fax |
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Authorized Official
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Title or Position | PD
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Name | NELLY TUTUWAN
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Credential | MA
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Telephone | 703-509-8778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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