Provider Demographics
NPI:1689060469
Name:DIGNITY-CARE HOME HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:DIGNITY-CARE HOME HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RABIATU
Authorized Official - Middle Name:
Authorized Official - Last Name:BANGURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-459-5645
Mailing Address - Street 1:9645 FRANKLIN WOODS PL
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-2344
Mailing Address - Country:US
Mailing Address - Phone:703-459-5645
Mailing Address - Fax:703-372-2122
Practice Address - Street 1:7630 LITTLE RIVER TURN PIKE, ANNANDALE II
Practice Address - Street 2:SUITE 316
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003
Practice Address - Country:US
Practice Address - Phone:571-347-7361
Practice Address - Fax:571-347-7637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-08
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 253Z00000X, 372600000X, 3747A0650X, 385H00000X
VAHCO151258251B00000X, 251E00000X, 251F00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No251B00000XAgenciesCase Management
No251F00000XAgenciesHome InfusionGroup - Single Specialty
No251J00000XAgenciesNursing CareGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Single Specialty
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
HCO231272OtherVA DEPARTMENT OF HEALTH