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General NPI Number Information
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NPI Number | 1659452233
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Entity Type | Organization
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Legal Business Name | DALECARE COMPANION SERVICES INC
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 02/01/2008
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Provider Practice Location Address
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Address Line | 7406 ALBAN STATION CT SUITE # A106
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City | SPRINGFIELD
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State | VA
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Zip | 22150-2329
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Country | US
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Telephone | 703-440-0755
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Fax | 703-440-0756
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Provider Business Mailing Address
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Address Line | 7406 ALBAN STATION CT SUITE # A106
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City | SPRINGFIELD
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State | VA
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Zip | 22150-2329
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Country | US
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Telephone | 703-440-0755
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Fax | 703-440-0756
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. AHMED HERSI ISSA
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Credential |
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Telephone | 703-440-0755
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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-07298
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License Number State | VA
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