MEDICARE: BEST LIFE 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	251E00000X	Home Health Agency		VA

General Provider Information

NPI Number	:	1689908881
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEST LIFE HOME HEALTH CARE LLC

Provider Business Mailing Address
First Line	:	3219 COLUMBIA PIKE STE 300B
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22204-4358
Country	:	US
Telephone Number	:	571-431-6904
Fax Number	:	571-431-6903

Provider Business Practice Location Address
First Line	:	3219 COLUMBIA PIKE STE 300B
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22204-4358
Country	:	US
Telephone Number	:	571-431-6904
Fax Number	:	571-431-6903

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. ERIC BURTON GRAVES
Credential	:
Telephone Number	:	571-431-6904

Provider Enumeration Date	:	09/22/2009
Last Update Date	:	09/22/2009

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