Provider Demographics
NPI:1134356082
Name:HOME CARE PROVIDERS LLC
Entity type:Organization
Organization Name:HOME CARE PROVIDERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WONDWOSSEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAILE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-585-0738
Mailing Address - Street 1:5881 LEESBURG PIKE
Mailing Address - Street 2:SUITE 504
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22041-2314
Mailing Address - Country:US
Mailing Address - Phone:703-998-4080
Mailing Address - Fax:703-998-4081
Practice Address - Street 1:5881 LEESBURG PIKE
Practice Address - Street 2:SUITE 504
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22041-2314
Practice Address - Country:US
Practice Address - Phone:703-998-4080
Practice Address - Fax:703-998-4081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-18
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAT005944251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health