Provider Demographics
NPI:1821264508
Name:CONNECT HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:CONNECT HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HEIKAL
Authorized Official - Middle Name:IBRAHIM
Authorized Official - Last Name:KENNEDED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-920-1212
Mailing Address - Street 1:6066 LEESBURG PIKE
Mailing Address - Street 2:STE. 200C
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22041-2234
Mailing Address - Country:US
Mailing Address - Phone:703-920-1212
Mailing Address - Fax:
Practice Address - Street 1:6066 LEESBURG PIKE
Practice Address - Street 2:STE 200C
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22041-2234
Practice Address - Country:US
Practice Address - Phone:703-920-1212
Practice Address - Fax:703-920-1215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-02
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO 13453251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAHCO 13453OtherCOMMON WEALTH VIRGINIA DEPARTMENT OF HEALTH