Provider Demographics
NPI:1518677962
Name:TYSONS HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:TYSONS HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALTERNATE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:IRFAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:MIRZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-861-5527
Mailing Address - Street 1:1749 OLD MEADOW RD STE 400
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-4325
Mailing Address - Country:US
Mailing Address - Phone:917-861-5527
Mailing Address - Fax:
Practice Address - Street 1:1749 OLD MEADOW RD STE 400
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-4325
Practice Address - Country:US
Practice Address - Phone:703-873-7863
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty