Provider Demographics
NPI:1487659652
Name:AMERICAN HEALTH HOME CARE GROUP, INC
Entity Type:Organization
Organization Name:AMERICAN HEALTH HOME CARE GROUP, INC
Other - Org Name:AMERICAN HEALTH CARE PROFESSIONALS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:CLISHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MBA
Authorized Official - Phone:703-319-3801
Mailing Address - Street 1:120 BEULAH RD NE
Mailing Address - Street 2:STE 201
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4745
Mailing Address - Country:US
Mailing Address - Phone:703-319-3801
Mailing Address - Fax:703-319-3805
Practice Address - Street 1:120 BEULAH RD NE
Practice Address - Street 2:STE 201
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4745
Practice Address - Country:US
Practice Address - Phone:703-319-3801
Practice Address - Fax:703-319-3805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA497536251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA491561OtherHOSPICE
VA497536Medicare ID - Type UnspecifiedHOME HEALTH