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General NPI Number Information
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NPI Number | 1407377682
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Entity Type | Organization
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Legal Business Name | KISSINGER HEALTHCARE ENTERPRISES, LLC
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Dates
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Enumeration Date | 06/28/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3921 OLD LEE HWY STE 71C
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City | FAIRFAX
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State | VA
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Zip | 22030-2429
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Country | US
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Telephone | 703-992-7420
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Fax | 703-992-7402
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Provider Business Mailing Address
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Address Line | 3921 OLD LEE HWY STE 71C
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City | FAIRFAX
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State | VA
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Zip | 22030-2429
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Country | US
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Telephone | 703-992-7420
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Fax | 703-992-7402
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Authorized Official
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Title or Position | MEMBER & ADMINISTRATOR
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Name | DONALD KISSINGER
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Credential | CPA, JD, LL.M.
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Telephone | 703-992-7420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | HCO-17622
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number | HCO-17622
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | HCO-17622
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License Number State | VA
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Taxonomy #5
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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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