Provider Demographics
NPI:1578101606
Name:PASSION FOR CARE LLC
Entity Type:Organization
Organization Name:PASSION FOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:MALIA
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:CNA/PROVIDER LICENSE
Authorized Official - Phone:571-269-3174
Mailing Address - Street 1:8300 BOONE BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2681
Mailing Address - Country:US
Mailing Address - Phone:703-714-9524
Mailing Address - Fax:
Practice Address - Street 1:8300 BOONE BLVD STE 500
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-2681
Practice Address - Country:US
Practice Address - Phone:703-714-9524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-19
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAA60819460Medicaid