Provider Demographics
NPI:1982218699
Name:HALLA HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:HALLA HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FAEDOWSA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ISMAIL
Authorized Official - Suffix:
Authorized Official - Credentials:HOME HEALTHCARE
Authorized Official - Phone:571-528-8629
Mailing Address - Street 1:44081 PIPELINE PLZ STE 100-2
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-5891
Mailing Address - Country:US
Mailing Address - Phone:571-918-0589
Mailing Address - Fax:703-570-6027
Practice Address - Street 1:44081 PIPELINE PLZ STE 100-2
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-5891
Practice Address - Country:US
Practice Address - Phone:571-918-0589
Practice Address - Fax:703-570-6027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health