Provider Demographics
NPI:1982489795
Name:PRINCESS HOMECARE
Entity Type:Organization
Organization Name:PRINCESS HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:NOORHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ISHAQ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-401-9366
Mailing Address - Street 1:5211 SIDEBURN RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22032-2641
Mailing Address - Country:US
Mailing Address - Phone:703-401-9366
Mailing Address - Fax:
Practice Address - Street 1:13800 COPPERMINE RD
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171-6163
Practice Address - Country:US
Practice Address - Phone:571-561-8024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-29
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care