Provider Demographics
NPI:1336490390
Name:VIRGINIA HOME CARE SERVICES, INC.
Entity Type:Organization
Organization Name:VIRGINIA HOME CARE SERVICES, INC.
Other - Org Name:1 VIRGINIA HOME CARE SERVICES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROUSTAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ALIVERDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-822-5252
Mailing Address - Street 1:2575 CHAIN BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22181-5576
Mailing Address - Country:US
Mailing Address - Phone:703-822-5252
Mailing Address - Fax:703-649-6303
Practice Address - Street 1:2575 CHAIN BRIDGE RD
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22181-5576
Practice Address - Country:US
Practice Address - Phone:703-822-5252
Practice Address - Fax:703-649-6303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-30
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-14905251B00000X, 3747P1801X, 385H00000X
251E00000X, 251J00000X, 251X00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome HealthGroup - Single Specialty
No251J00000XAgenciesNursing CareGroup - Single Specialty
No251X00000XAgenciesSupports Brokerage
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1336490390Medicaid