Provider Demographics
NPI:1619561602
Name:AMAZING HOME LLC
Entity Type:Organization
Organization Name:AMAZING HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RHODA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPPOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-878-5463
Mailing Address - Street 1:44121 HARRY BYRD HWY STE 255
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-5671
Mailing Address - Country:US
Mailing Address - Phone:678-878-5463
Mailing Address - Fax:
Practice Address - Street 1:44121 HARRY BYRD HWY STE 255
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-5671
Practice Address - Country:US
Practice Address - Phone:678-878-5463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health