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General NPI Number Information
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NPI Number | 1811222953
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Entity Type | Organization
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Legal Business Name | HOMECARE ALTERNATIVE LLC
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Dates
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Enumeration Date | 10/07/2009
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Last Update Date | 10/29/2014
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Provider Practice Location Address
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Address Line | 209 ELDEN ST STE 303
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City | HERNDON
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State | VA
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Zip | 20170-4847
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Country | US
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Telephone | 703-862-6314
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 355
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City | LOVETTSVILLE
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State | VA
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Zip | 20180-0355
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Country | US
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Telephone | 301-717-1477
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Fax | 540-822-4398
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Authorized Official
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Title or Position | MANAGER
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Name | SVETLANA OUCHAKOV
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Credential |
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Telephone | 703-862-6314
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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 | 0924554
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License Number State | VA
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