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General NPI Number Information
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NPI Number | 1598070880
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Entity Type | Organization
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Legal Business Name | EMMANUEL HOME CARE AGENCY
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Dates
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Enumeration Date | 08/11/2010
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Last Update Date | 05/07/2012
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Provider Practice Location Address
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Address Line | 6911 RICHMOND HWY SUITE 245
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City | ALEXANDRIA
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State | VA
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Zip | 22306-1842
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Country | US
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Telephone | 703-660-6950
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Fax |
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Provider Business Mailing Address
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Address Line | 6911 RICHMOND HWY SUITE 245
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City | ALEXANDRIA
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State | VA
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Zip | 22306-1842
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Country | US
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Telephone | 703-660-6950
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Fax |
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Authorized Official
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Title or Position | FINANCE MANAGER
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Name | MR. JOSEPH ADETUNJI
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Credential |
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Telephone | 703-660-6950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | HCO-12677
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | HC0-12677
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | HCO-12677
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | HCO-12677
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License Number State | VA
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Taxonomy #5
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HCO-11677
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License Number State | VA
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