Provider Demographics
NPI:1518215227
Name:SENIOR HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:SENIOR HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRESHTA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAWABI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:571-259-9384
Mailing Address - Street 1:12801 WORLDGATE DR
Mailing Address - Street 2:SUITE 500
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-4393
Mailing Address - Country:US
Mailing Address - Phone:571-259-9384
Mailing Address - Fax:571-259-9384
Practice Address - Street 1:12801 WORLDGATE DR
Practice Address - Street 2:SUITE 500
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4393
Practice Address - Country:US
Practice Address - Phone:571-259-9384
Practice Address - Fax:571-259-9384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health