Provider Demographics
NPI:1033752449
Name:1ST YOU HEALTHCARE PROFESSIONALS, LLC
Entity Type:Organization
Organization Name:1ST YOU HEALTHCARE PROFESSIONALS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RADIA
Authorized Official - Middle Name:T
Authorized Official - Last Name:ADEM
Authorized Official - Suffix:
Authorized Official - Credentials:RN/BSN
Authorized Official - Phone:571-501-2552
Mailing Address - Street 1:13512 MINNIEVILLE RD STE 260
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-4208
Mailing Address - Country:US
Mailing Address - Phone:571-501-2552
Mailing Address - Fax:
Practice Address - Street 1:13512 MINNIEVILLE RD STE 260
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-4208
Practice Address - Country:US
Practice Address - Phone:571-501-2552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-18
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty