Provider Demographics
NPI:1629552476
Name:HOME HEALTH CARE VA LLC
Entity type:Organization
Organization Name:HOME HEALTH CARE VA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FAREED
Authorized Official - Middle Name:
Authorized Official - Last Name:PUSHTOONYAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-422-4662
Mailing Address - Street 1:2700 NEABSCO COMMON PL STE 101
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-6767
Mailing Address - Country:US
Mailing Address - Phone:571-310-1880
Mailing Address - Fax:
Practice Address - Street 1:2700 NEABSCO COMMON PL STE 101
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-6767
Practice Address - Country:US
Practice Address - Phone:571-310-1880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-18
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child