Provider Demographics
NPI:1700030392
Name:DALGROW CORPORATION
Entity Type:Organization
Organization Name:DALGROW CORPORATION
Other - Org Name:DALGROW HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:IDOWU
Authorized Official - Last Name:OGBONLOWO
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, MS
Authorized Official - Phone:703-878-3385
Mailing Address - Street 1:1338 HORNER RD
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-1738
Mailing Address - Country:US
Mailing Address - Phone:703-492-0113
Mailing Address - Fax:703-492-0388
Practice Address - Street 1:1338 HORNER RD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-1738
Practice Address - Country:US
Practice Address - Phone:703-492-0113
Practice Address - Fax:703-492-0388
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DALGROW CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-09
Last Update Date:2008-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-09530251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health