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NPI Code Detail

MEDICARE: GOODWIN HOUSE HOME AND COMMUNITY BASED SERVICES

MEDICARE: GOODWIN HOUSE HOME AND COMMUNITY BASED SERVICES
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
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1356673313
Entity Type Code : Organization
Provider Name (Legal Business Name) : GOODWIN HOUSE HOME AND COMMUNITY BASED SERVICES
Provider Business Mailing Address
First Line : 4800 FILLMORE AVE
Second Line :
City : ALEXANDRIA
State : VA
Zip : 22311-5070
Country : US
Telephone Number : 703-824-1390
Fax Number : 703-782-8835
Provider Business Practice Location Address
First Line : 3440 S JEFFERSON ST
Second Line :
City : FALLS CHURCH
State : VA
Zip : 22041-3145
Country : US
Telephone Number : 703-824-1390
Fax Number : 703-828-9892
Authorized Official
Title or Position : VP BUSINESS DEVELOPMENT
Name : ANDREW MARK SIEGEL
Credential :
Telephone Number : 703-578-7554
Provider Enumeration Date : 02/02/2010
Last Update Date : 07/24/2025

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Directions to “GOODWIN HOUSE HOME AND COMMUNITY BASED SERVICES ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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