Provider Demographics
NPI:1821599523
Name:MY HOME COMPANION
Entity Type:Organization
Organization Name:MY HOME COMPANION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:CARLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-919-8811
Mailing Address - Street 1:8136 OLD KEENE MILL RD STE B308
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22152-1857
Mailing Address - Country:US
Mailing Address - Phone:833-286-9466
Mailing Address - Fax:
Practice Address - Street 1:8136 OLD KEENE MILL ROAD
Practice Address - Street 2:B-308
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22031
Practice Address - Country:US
Practice Address - Phone:833-286-9466
Practice Address - Fax:571-348-1264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-27
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
372600000X, 374T00000X, 374U00000X
VAHCO-1800376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No374T00000XNursing Service Related ProvidersReligious Nonmedical Nursing PersonnelGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty