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General NPI Number Information
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NPI Number | 1588487326
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Entity Type | Organization
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Legal Business Name | EXALT HEALTH CARE LLC
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Dates
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Enumeration Date | 10/31/2024
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 5290 SHAWNEE RD STE 200
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City | ALEXANDRIA
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State | VA
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Zip | 22312-2381
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Country | US
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Telephone | 571-276-4141
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Fax |
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Provider Business Mailing Address
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Address Line | 567 COASTAL AVE
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City | STAFFORD
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State | VA
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Zip | 22554-6857
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Country | US
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Telephone | 571-276-4141
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MATILDA TAGOE
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Credential | RN
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Telephone | 571-276-4141
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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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