Provider Demographics
NPI:1285832519
Name:1ST AMERICAN HOME HEALTH CARE SERVICES, INC
Entity Type:Organization
Organization Name:1ST AMERICAN HOME HEALTH CARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SERKALEM
Authorized Official - Middle Name:
Authorized Official - Last Name:FISSEHA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:703-922-9555
Mailing Address - Street 1:6216 A OLD FRANCONIA RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-3401
Mailing Address - Country:US
Mailing Address - Phone:703-922-9555
Mailing Address - Fax:703-922-9557
Practice Address - Street 1:6216 A OLD FRANCONIA RD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-3401
Practice Address - Country:US
Practice Address - Phone:703-922-9555
Practice Address - Fax:703-922-9557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-09
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-08418251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health