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General NPI Number Information
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NPI Number | 1770190639
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Entity Type | Organization
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Legal Business Name | STEADFAST HOME CARE SERVICES, LLC
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Dates
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Enumeration Date | 09/24/2020
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 7918 JONES BRANCH DR STE 400
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City | MC LEAN
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State | VA
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Zip | 22102-3319
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Country | US
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Telephone | 301-437-3550
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Fax |
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Provider Business Mailing Address
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Address Line | 7918 JONES BRANCH DR STE 400
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City | MC LEAN
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State | VA
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Zip | 22102-3319
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Country | US
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Telephone | 703-946-1664
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MOSUN OLUSANYA
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Credential |
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Telephone | 703-946-1664
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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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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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