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General NPI Number Information
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NPI Number | 1356673313
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Entity Type | Organization
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Legal Business Name | GOODWIN HOUSE HOME AND COMMUNITY BASED SERVICES
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Dates
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Enumeration Date | 02/02/2010
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 3440 S JEFFERSON ST
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City | FALLS CHURCH
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State | VA
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Zip | 22041-3145
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Country | US
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Telephone | 703-824-1390
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Fax | 703-828-9892
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Provider Business Mailing Address
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Address Line | 4800 FILLMORE AVE
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City | ALEXANDRIA
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State | VA
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Zip | 22311-5070
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Country | US
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Telephone | 703-824-1390
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Fax | 703-782-8835
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Authorized Official
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Title or Position | VP BUSINESS DEVELOPMENT
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Name | ANDREW MARK SIEGEL
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Credential |
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Telephone | 703-578-7554
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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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