Provider Demographics
NPI:1609363365
Name:NOVA ELDERLY HOME CARE LLC
Entity Type:Organization
Organization Name:NOVA ELDERLY HOME CARE LLC
Other - Org Name:VISITING ANGELS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TEWODROS
Authorized Official - Middle Name:W
Authorized Official - Last Name:EYOB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-333-5086
Mailing Address - Street 1:85 S BRAGG ST STE 501
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22312-2798
Mailing Address - Country:US
Mailing Address - Phone:703-333-5086
Mailing Address - Fax:703-725-3981
Practice Address - Street 1:85 S BRAGG ST STE 501
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22312-2798
Practice Address - Country:US
Practice Address - Phone:703-333-5086
Practice Address - Fax:703-725-3981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-18
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health