Provider Demographics
NPI:1013653138
Name:MAXBEL HOME HEALTH INC
Entity Type:Organization
Organization Name:MAXBEL HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MABEL
Authorized Official - Middle Name:TIMA
Authorized Official - Last Name:BREMPONG
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:703-225-8713
Mailing Address - Street 1:14916 SPRIGGS TREE LN
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-3199
Mailing Address - Country:US
Mailing Address - Phone:703-225-8713
Mailing Address - Fax:
Practice Address - Street 1:14916 SPRIGGS TREE LN
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-3199
Practice Address - Country:US
Practice Address - Phone:703-225-8713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-11
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA30017532580001Medicaid