Provider Demographics
NPI:1720548068
Name:SBIHI HOSPITALITY GROUP, LLC
Entity Type:Organization
Organization Name:SBIHI HOSPITALITY GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:SBIHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-577-6771
Mailing Address - Street 1:13347 CONNOR DR APT F
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-3047
Mailing Address - Country:US
Mailing Address - Phone:703-577-6771
Mailing Address - Fax:
Practice Address - Street 1:4100 MONUMENT CORNER DR STE 400B
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-8610
Practice Address - Country:US
Practice Address - Phone:703-718-5455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SBIHI HOSPITALITY GROUP, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-22
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care