Provider Demographics
NPI:1609542703
Name:AMANI HOME CARE INC.
Entity Type:Organization
Organization Name:AMANI HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DOMICIAN
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:KUBOJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-314-6454
Mailing Address - Street 1:4012 WILLIAMSBURG CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22032-1139
Mailing Address - Country:US
Mailing Address - Phone:866-262-6483
Mailing Address - Fax:855-918-1011
Practice Address - Street 1:4012 WILLIAMSBURG CT
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22032-1139
Practice Address - Country:US
Practice Address - Phone:866-262-6483
Practice Address - Fax:855-918-1011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health