=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871742767
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AMERICAN CENTER FOR HEALTH CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/16/2008
-----------------------------------------------------
Last Update Date | 11/12/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8647 MATHIS AVE SUITE # 202
-----------------------------------------------------
City | MANASSAS
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 20110-8454
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-368-6199
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8647 MATHIS AVE SUITE # 202
-----------------------------------------------------
City | MANASSAS
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 20110-8454
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-368-6199
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FOUNDER, PRESIDENT
-----------------------------------------------------
Name | MR. JOSEPH DALE BRISENO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 703-368-6199
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------