Provider Demographics
NPI:1336487537
Name:OCTOBER VENTURES LLC
Entity Type:Organization
Organization Name:OCTOBER VENTURES LLC
Other - Org Name:OPTIMUMCARE HOME CARE SERVCES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANIM
Authorized Official - Middle Name:ADDO
Authorized Official - Last Name:SAMPONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-490-8003
Mailing Address - Street 1:3683 FETTLER PARK DR
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22025-2049
Mailing Address - Country:US
Mailing Address - Phone:703-490-8003
Mailing Address - Fax:703-995-4585
Practice Address - Street 1:3683 FETTLER PARK DR
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22025-2049
Practice Address - Country:US
Practice Address - Phone:703-490-8003
Practice Address - Fax:703-995-4585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-22
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO 13919251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health