Provider Demographics
NPI:1811543721
Name:PROSPERITY HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:PROSPERITY HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-870-1670
Mailing Address - Street 1:5653 COLUMBIA PIKE STE 200
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22041-2873
Mailing Address - Country:US
Mailing Address - Phone:703-870-1670
Mailing Address - Fax:703-544-9299
Practice Address - Street 1:5653 COLUMBIA PIKE STE 200
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22041-2873
Practice Address - Country:US
Practice Address - Phone:703-870-1670
Practice Address - Fax:703-544-9299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty