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General NPI Number Information
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NPI Number | 1235181264
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Entity Type | Organization
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Legal Business Name | ADVANCE HOME HEALTH CARE, LLC
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 03/03/2008
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Provider Practice Location Address
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Address Line | 6 PIDGEON HILL DR SUITE 130-A
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City | STERLING
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State | VA
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Zip | 20165-6146
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Country | US
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Telephone | 571-246-3622
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Fax | 703-421-1461
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Provider Business Mailing Address
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Address Line | 6 PIDGEON HILL DR SUITE 130-A
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City | STERLING
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State | VA
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Zip | 20165-6146
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Country | US
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Telephone | 571-246-3622
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Fax | 703-421-1461
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Authorized Official
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Title or Position | PHYSICAL THERAPIST, OWNER
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Name | MR. CONSTANTINE XANTHAKYS
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Credential | MS, PT
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Telephone | 571-246-3622
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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-353
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License Number State | VA
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