Provider Demographics
NPI:1811667066
Name:AMAZING ACE HOME CARE LLC
Entity type:Organization
Organization Name:AMAZING ACE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WANSI
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:703-347-1508
Mailing Address - Street 1:1693 WINTERWOOD CT
Mailing Address - Street 2:
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-2990
Mailing Address - Country:US
Mailing Address - Phone:703-347-1508
Mailing Address - Fax:
Practice Address - Street 1:12903 FRAMINGHAM CT
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171-2616
Practice Address - Country:US
Practice Address - Phone:703-340-0217
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-19
Last Update Date:2021-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities