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General NPI Number Information
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NPI Number | 1609897586
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Entity Type | Organization
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Legal Business Name | KENOLY HOME CARE, LLC
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 8303 ARLINGTON BLVD SUITE 210
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City | FAIRFAX
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State | VA
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Zip | 22031-2903
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Country | US
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Telephone | 703-573-3852
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Fax | 703-573-3853
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Provider Business Mailing Address
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Address Line | 8303 ARLINGTON BLVD SUITE 210
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City | FAIRFAX
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State | VA
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Zip | 22031-2903
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Country | US
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Telephone | 703-573-3852
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Fax | 703-573-3853
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Authorized Official
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Title or Position | ADMINISTRATOR/CEO
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Name | MS. KEKELWA NOLIYA DALL
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Credential |
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Telephone | 703-573-3852
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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 | HCO 264
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | HCO264
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License Number State | VA
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