Provider Demographics
NPI:1386002442
Name:SWEET VIRGINIA CARE LLC
Entity Type:Organization
Organization Name:SWEET VIRGINIA CARE LLC
Other - Org Name:BRIGHTSTAR CARE- LEESBURG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CONRAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-496-4616
Mailing Address - Street 1:21035 SYCOLIN RD STE 55
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-4311
Mailing Address - Country:US
Mailing Address - Phone:703-496-4616
Mailing Address - Fax:
Practice Address - Street 1:21035 SYCOLIN RD STE 55
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-4311
Practice Address - Country:US
Practice Address - Phone:703-496-4616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-04
Last Update Date:2023-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
VAHCO-161185253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care