Provider Demographics
NPI:1588180525
Name:HOME HEALTH SERVICES OF NOVA, LLC
Entity Type:Organization
Organization Name:HOME HEALTH SERVICES OF NOVA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GLADYS
Authorized Official - Middle Name:
Authorized Official - Last Name:IBEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-217-1746
Mailing Address - Street 1:42758 HAY RD
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-3515
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:44081 PIPELINE PLZ # 105-2
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-5891
Practice Address - Country:US
Practice Address - Phone:703-687-6064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-22
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health