Provider Demographics
NPI:1265898571
Name:BBA HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:BBA HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:PHIROM
Authorized Official - Last Name:BREADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-606-3806
Mailing Address - Street 1:23420 SUMMERSTOWN PLACE
Mailing Address - Street 2:
Mailing Address - City:DULLES
Mailing Address - State:VA
Mailing Address - Zip Code:20166
Mailing Address - Country:US
Mailing Address - Phone:703-606-3806
Mailing Address - Fax:
Practice Address - Street 1:23420 SUMMERSTOWN PL
Practice Address - Street 2:
Practice Address - City:DULLES
Practice Address - State:VA
Practice Address - Zip Code:20166-2178
Practice Address - Country:US
Practice Address - Phone:703-606-3806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-04
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAHCO-233043OtherBBA LICENSE
VA30017487950001Medicaid