MEDICARE: CONCORD HOME HEALTHCARE, 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

General Provider Information

NPI Number	:	1952033516
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONCORD HOME HEALTHCARE, LLC

Provider Business Mailing Address
First Line	:	201 PARK WASHINGTON CT STE 100
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22046-4527
Country	:	US
Telephone Number	:	703-364-9026
Fax Number	:	571-449-6982

Provider Business Practice Location Address
First Line	:	201 PARK WASHINGTON CT STE 100
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22046-4527
Country	:	US
Telephone Number	:	703-364-9026
Fax Number	:	571-449-6982

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. ASHA HASSAN
Credential	:
Telephone Number	:	703-364-9026

Provider Enumeration Date	:	06/30/2022
Last Update Date	:	06/30/2022

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