Provider Demographics
NPI:1174708291
Name:BEATRIZ ELDERLY CARE
Entity type:Organization
Organization Name:BEATRIZ ELDERLY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:GISELLE
Authorized Official - Last Name:AZANEDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-344-1022
Mailing Address - Street 1:4101 CHAIN BRIDGE RD STE 308
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-4105
Mailing Address - Country:US
Mailing Address - Phone:703-344-1022
Mailing Address - Fax:
Practice Address - Street 1:4101 CHAIN BRIDGE RD STE 308
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-4105
Practice Address - Country:US
Practice Address - Phone:703-344-1022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-08462251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health