Provider Demographics
NPI:1558444547
Name:ACTUAL CARE
Entity Type:Organization
Organization Name:ACTUAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:AMENU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-273-0783
Mailing Address - Street 1:19455 DEERFIELD AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-8446
Mailing Address - Country:US
Mailing Address - Phone:703-273-0783
Mailing Address - Fax:
Practice Address - Street 1:19455 DEERFIELD AVE STE 310
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-8446
Practice Address - Country:US
Practice Address - Phone:703-273-0783
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA497567Medicare Oscar/Certification