Provider Demographics
NPI:1649718396
Name:HUNT COUNTRY HEALTH SERVICES
Entity type:Organization
Organization Name:HUNT COUNTRY HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DORIN
Authorized Official - Middle Name:
Authorized Official - Last Name:TAKWA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:301-537-0751
Mailing Address - Street 1:31 S BRADDOCK ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-4144
Mailing Address - Country:US
Mailing Address - Phone:540-773-4941
Mailing Address - Fax:540-773-3345
Practice Address - Street 1:31 S BRADDOCK ST STE 106
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601
Practice Address - Country:US
Practice Address - Phone:304-707-5605
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUNT COUNTRY HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-02
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO171257251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health