Provider Demographics
NPI:1033579735
Name:HOLY HOME HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:HOLY HOME HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CELESTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:NIYONGABO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-538-2503
Mailing Address - Street 1:8201 GREENSBORO DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-3810
Mailing Address - Country:US
Mailing Address - Phone:703-287-4235
Mailing Address - Fax:703-995-0934
Practice Address - Street 1:8201 GREENSBORO DR
Practice Address - Street 2:SUITE 300
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-3810
Practice Address - Country:US
Practice Address - Phone:703-287-4235
Practice Address - Fax:703-995-0934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-161395251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health