MEDICARE: BLUE RIDGE HOME HEALTH CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1114727716
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLUE RIDGE HOME HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	3060 WILLIAMS DR STE 3077
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22031-4667
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3060 WILLIAMS DR STE 3077
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22031-4667
Country	:	US
Telephone Number	:	571-491-8361
Fax Number	:

Authorized Official
Title or Position	:	ADMIN
Name	:	IRMA ROSA JUAREZ ESCALANTE
Credential	:
Telephone Number	:	571-491-8361

Provider Enumeration Date	:	03/14/2025
Last Update Date	:	03/14/2025

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Directions to “BLUE RIDGE HOME HEALTH CARE LLC ” Practice Location

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