Provider Demographics
NPI:1053448480
Name:HOME HEALTH CONNECTION, INC.
Entity Type:Organization
Organization Name:HOME HEALTH CONNECTION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHAHIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:MAFI
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:301-718-0112
Mailing Address - Street 1:PO BOX 31105
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20824-1105
Mailing Address - Country:US
Mailing Address - Phone:703-684-3799
Mailing Address - Fax:703-860-2519
Practice Address - Street 1:12007 SUNRISE VALLEY DR
Practice Address - Street 2:SUITE 103
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191
Practice Address - Country:US
Practice Address - Phone:703-684-3799
Practice Address - Fax:703-860-2519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 376K00000X
VAHCO-07112314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty
No251E00000XAgenciesHome Health
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA008703779Medicaid