Provider Demographics
NPI:1881201861
Name:HOME CARE ASSOCIATES OF VA
Entity type:Organization
Organization Name:HOME CARE ASSOCIATES OF VA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MAMUN
Authorized Official - Middle Name:
Authorized Official - Last Name:JITU
Authorized Official - Suffix:
Authorized Official - Credentials:HOME CARE
Authorized Official - Phone:917-657-3705
Mailing Address - Street 1:24338 WINDING WILLOW CT
Mailing Address - Street 2:
Mailing Address - City:ALDIE
Mailing Address - State:VA
Mailing Address - Zip Code:20105-5941
Mailing Address - Country:US
Mailing Address - Phone:917-657-3705
Mailing Address - Fax:
Practice Address - Street 1:24338 WINDING WILLOW CT
Practice Address - Street 2:
Practice Address - City:ALDIE
Practice Address - State:VA
Practice Address - Zip Code:20105-5941
Practice Address - Country:US
Practice Address - Phone:917-657-3705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care