Provider Demographics
NPI:1477723377
Name:DEPENDABLE HOME HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:DEPENDABLE HOME HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ZENA
Authorized Official - Middle Name:NONE
Authorized Official - Last Name:AYALEW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-370-2300
Mailing Address - Street 1:50 S PICKETT ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-7207
Mailing Address - Country:US
Mailing Address - Phone:703-370-2300
Mailing Address - Fax:703-370-2302
Practice Address - Street 1:50 S PICKETT ST
Practice Address - Street 2:SUITE 200
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-7207
Practice Address - Country:US
Practice Address - Phone:703-370-2300
Practice Address - Fax:703-370-2302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-06
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-08361251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010279879Medicaid