Provider Demographics
NPI:1790663433
Name:VIRUNGA HOME CARE AGENCY, LLC
Entity type:Organization
Organization Name:VIRUNGA HOME CARE AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:NGONGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-209-6433
Mailing Address - Street 1:526 SNAPDRAGON DR
Mailing Address - Street 2:
Mailing Address - City:PITTSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18641-3205
Mailing Address - Country:US
Mailing Address - Phone:570-209-6433
Mailing Address - Fax:
Practice Address - Street 1:526 SNAPDRAGON DR
Practice Address - Street 2:
Practice Address - City:PITTSTON
Practice Address - State:PA
Practice Address - Zip Code:18641-3205
Practice Address - Country:US
Practice Address - Phone:570-209-6433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health