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General NPI Number Information
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NPI Number | 1619118528
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Entity Type | Organization
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Legal Business Name | FIVE STAR HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 03/23/2009
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 14420 ALBEMARLE POINT PL STE 150
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City | CHANTILLY
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State | VA
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Zip | 20151-1690
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Country | US
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Telephone | 703-662-7500
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Fax | 703-661-6397
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Provider Business Mailing Address
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Address Line | 14420 ALBEMARLE POINT PL STE 150
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City | CHANTILLY
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State | VA
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Zip | 20151-1690
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Country | US
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Telephone | 703-662-7500
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Fax | 703-661-6397
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Authorized Official
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Title or Position | CEO
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Name | JOHNNY L WILKINSON
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Credential |
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Telephone | 703-662-7500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | JCAHO 518135
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | JCAHO 518135
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License Number State | VA
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