Provider Demographics
NPI:1023320330
Name:VSN PROFESSIONAL HEALTHCARE
Entity type:Organization
Organization Name:VSN PROFESSIONAL HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FRANCESS
Authorized Official - Middle Name:ZAINAB
Authorized Official - Last Name:KAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:571-432-0467
Mailing Address - Street 1:10875 MAIN ST
Mailing Address - Street 2:SUITE 203
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-4732
Mailing Address - Country:US
Mailing Address - Phone:703-642-1533
Mailing Address - Fax:703-642-1710
Practice Address - Street 1:10875 MAIN STREET
Practice Address - Street 2:STE. 203
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-1677
Practice Address - Country:US
Practice Address - Phone:703-642-1533
Practice Address - Fax:703-642-1710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-02
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-10579251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAHCO-10579OtherBUSINESS LICENSURE