Provider Demographics
NPI:1659452233
Name:DALECARE COMPANION SERVICES INC
Entity Type:Organization
Organization Name:DALECARE COMPANION SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:HERSI
Authorized Official - Last Name:ISSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-440-0755
Mailing Address - Street 1:7406 ALBAN STATION CT
Mailing Address - Street 2:SUITE # A106
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-2329
Mailing Address - Country:US
Mailing Address - Phone:703-440-0755
Mailing Address - Fax:703-440-0756
Practice Address - Street 1:7406 ALBAN STATION CT
Practice Address - Street 2:SUITE # A106
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-2329
Practice Address - Country:US
Practice Address - Phone:703-440-0755
Practice Address - Fax:703-440-0756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-07298251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health