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General NPI Number Information
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NPI Number | 1891000824
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Entity Type | Organization
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Legal Business Name | KWALITY HOME CARE INC.
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Dates
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Enumeration Date | 08/13/2010
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Last Update Date | 11/24/2010
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Provider Practice Location Address
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Address Line | 2465 CENTREVILLE RD J17-713
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City | HERNDON
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State | VA
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Zip | 20171-4586
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Country | US
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Telephone | 703-955-3848
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Fax | 703-955-7375
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Provider Business Mailing Address
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Address Line | 2465 CENTREVILLE RD J17-713
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City | HERNDON
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State | VA
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Zip | 20171-4586
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Country | US
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Telephone | 703-955-3848
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Fax | 703-955-7375
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Authorized Official
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Title or Position | DIRECTOR NURSING
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Name | MR. ISSA KOROMA
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Credential |
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Telephone | 703-955-3848
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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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