Provider Demographics
NPI:1972258838
Name:SSK HEALTHCARE, LLC
Entity Type:Organization
Organization Name:SSK HEALTHCARE, LLC
Other - Org Name:HOMEWATCH CAREGIVERS OF MANASSAS - WOODBRIDGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMIRA
Authorized Official - Middle Name:S
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-490-7222
Mailing Address - Street 1:4391 RIDGEWOOD CENTER DR STE H
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-5399
Mailing Address - Country:US
Mailing Address - Phone:571-490-7222
Mailing Address - Fax:
Practice Address - Street 1:4391 RIDGEWOOD CENTER DR STE H
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-5399
Practice Address - Country:US
Practice Address - Phone:571-490-7222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-18
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care