Provider Demographics
NPI:1508497272
Name:VESTA HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:VESTA HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TAMIM
Authorized Official - Middle Name:
Authorized Official - Last Name:MOJADDIDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-332-9854
Mailing Address - Street 1:21954 TRACTION PL
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20164-4648
Mailing Address - Country:US
Mailing Address - Phone:571-207-6765
Mailing Address - Fax:
Practice Address - Street 1:21954 TRACTION PL
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20164-4648
Practice Address - Country:US
Practice Address - Phone:571-207-6765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health