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General NPI Number Information
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NPI Number | 1760061956
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Entity Type | Organization
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Legal Business Name | ADVANCED HOME CARE CONNECT, INC
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Dates
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Enumeration Date | 04/05/2021
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Last Update Date | 04/05/2021
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Provider Practice Location Address
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Address Line | 13190 CENTERPOINTE WAY 201
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City | WOODBRIDGE
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State | VA
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Zip | 22193-5286
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Country | US
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Telephone | 571-477-9568
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Fax | 571-364-0077
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Provider Business Mailing Address
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Address Line | 16622 RADCLIFFE LN
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City | WOODBRIDGE
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State | VA
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Zip | 22191-4436
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Country | US
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Telephone | 571-316-4404
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Fax | 571-364-0077
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Authorized Official
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Title or Position | CEO
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Name | ABDUKADIR SAID
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Credential | AM
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Telephone | 571-316-4404
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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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