Provider Demographics
NPI:1598424673
Name:AT HOME CARE LLC
Entity Type:Organization
Organization Name:AT HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:THODE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-797-8186
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:571-520-6700
Mailing Address - Fax:571-249-1304
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:571-520-6700
Practice Address - Fax:571-249-1304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care