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General NPI Number Information
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NPI Number | 1831707561
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Entity Type | Organization
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Legal Business Name | DECENA HOME CARE, LLC
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Dates
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Enumeration Date | 07/20/2020
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 13800 COPPERMINE RD # 130
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City | HERNDON
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State | VA
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Zip | 20171-6163
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Country | US
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Telephone | 571-508-7144
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Fax | 571-410-4085
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Provider Business Mailing Address
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Address Line | 13800 COPPERMINE RD # 130
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City | HERNDON
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State | VA
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Zip | 20171-6163
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Country | US
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Telephone | 571-508-7144
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Fax | 571-410-4085
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Authorized Official
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Title or Position | CEO ADMINISTRATOR
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Name | MR. PEPITO JIMENEZ DECENA JR.
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Credential | LPN
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Telephone | 571-508-7144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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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 | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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