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General NPI Number Information
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NPI Number | 1376346635
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Entity Type | Organization
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Legal Business Name | MEMORIES OF LIFE HOME CARE LLC
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Dates
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Enumeration Date | 03/31/2025
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 800 CORPORATE DR STE 343
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City | STAFFORD
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State | VA
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Zip | 22554-4889
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Country | US
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Telephone | 703-296-8864
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Fax |
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Provider Business Mailing Address
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Address Line | 2625 CAST OFF LOOP
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City | WOODBRIDGE
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State | VA
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Zip | 22191-1470
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Country | US
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Telephone | 703-296-8864
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | JOYCELINE OWUSU-DANKWAA
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Credential |
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Telephone | 703-296-8864
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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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