Provider Demographics
NPI:1376287219
Name:NORTHERN VA HOME HEALTHCARE LLC
Entity Type:Organization
Organization Name:NORTHERN VA HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BALENDU
Authorized Official - Middle Name:
Authorized Official - Last Name:TRIPATHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-981-2296
Mailing Address - Street 1:9730 KINGSBRIDGE DR APT 2
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-1691
Mailing Address - Country:US
Mailing Address - Phone:571-363-5086
Mailing Address - Fax:
Practice Address - Street 1:9730 KINGSBRIDGE DR APT 2
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-1691
Practice Address - Country:US
Practice Address - Phone:571-363-5086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-26
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care