Provider Demographics
NPI:1053079871
Name:AYAN TRANSITIONAL HOMES LLC
Entity Type:Organization
Organization Name:AYAN TRANSITIONAL HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NOOR
Authorized Official - Middle Name:
Authorized Official - Last Name:IMRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-659-7484
Mailing Address - Street 1:13212 KINNICUTT DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-5655
Mailing Address - Country:US
Mailing Address - Phone:703-659-7484
Mailing Address - Fax:
Practice Address - Street 1:13212 KINNICUTT DR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-5655
Practice Address - Country:US
Practice Address - Phone:703-659-7484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care