Provider Demographics
NPI:1104373521
Name:HEREFORD HOME CARE LLC
Entity Type:Organization
Organization Name:HEREFORD HOME CARE LLC
Other - Org Name:ASSISTING HANDS OF ALEXANDRIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-665-3722
Mailing Address - Street 1:1940 DUKE ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-3451
Mailing Address - Country:US
Mailing Address - Phone:703-665-3722
Mailing Address - Fax:703-634-5399
Practice Address - Street 1:1940 DUKE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-3451
Practice Address - Country:US
Practice Address - Phone:703-665-3722
Practice Address - Fax:703-634-5399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-171448251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health