MEDICARE: CAREGIVER STAFFING 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	:	1376492108
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAREGIVER STAFFING LLC

Provider Business Mailing Address
First Line	:	11166 FAIRFAX BLVD STE 300
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22030-5017
Country	:	US
Telephone Number	:	703-625-7570
Fax Number	:

Provider Business Practice Location Address
First Line	:	11166 FAIRFAX BLVD STE 300
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22030-5017
Country	:	US
Telephone Number	:	703-625-7570
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	DEXTER ATIENZA
Credential	:
Telephone Number	:	703-625-7570

Provider Enumeration Date	:	01/26/2026
Last Update Date	:	01/26/2026

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