Provider Demographics
NPI:1992178370
Name:1 CORINTHIANS HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:1 CORINTHIANS HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARBAJAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-801-1784
Mailing Address - Street 1:116R EDWARDS FERRY RD NE
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-2301
Mailing Address - Country:US
Mailing Address - Phone:703-801-1784
Mailing Address - Fax:888-861-1299
Practice Address - Street 1:116R EDWARDS FERRY RD NE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-2301
Practice Address - Country:US
Practice Address - Phone:703-801-1784
Practice Address - Fax:888-861-1299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO161325253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care