Provider Demographics
NPI:1407145691
Name:ALLIED HOME CARE, LLC
Entity Type:Organization
Organization Name:ALLIED HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:RN,
Authorized Official - Phone:703-752-1751
Mailing Address - Street 1:4900 LEESBURG PIKE
Mailing Address - Street 2:#214
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22302-1103
Mailing Address - Country:US
Mailing Address - Phone:703-752-1751
Mailing Address - Fax:703-842-6024
Practice Address - Street 1:4900 LEESBURG PIKE
Practice Address - Street 2:#214
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22302-1103
Practice Address - Country:US
Practice Address - Phone:703-752-1751
Practice Address - Fax:703-842-6024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-29
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
HCO-15714OtherHOME CARE ORGANIZATION LICENSE
HCO-15714OtherHOME CARE ORGANIZATION LICENSE