Provider Demographics
NPI:1508378779
Name:BRIGHTHOPE HOMECARE, LLC
Entity Type:Organization
Organization Name:BRIGHTHOPE HOMECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHI
Authorized Official - Middle Name:
Authorized Official - Last Name:ISIRIMAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-235-2261
Mailing Address - Street 1:7722 TEA TABLE DR
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-4707
Mailing Address - Country:US
Mailing Address - Phone:571-235-2261
Mailing Address - Fax:571-405-5440
Practice Address - Street 1:7722 TEA TABLE DR
Practice Address - Street 2:
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-4707
Practice Address - Country:US
Practice Address - Phone:571-235-2261
Practice Address - Fax:571-405-5440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-27
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA251E00000X
VAHCO-1755253Z00000X, 374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No251E00000XAgenciesHome Health
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty