# MONTCLAIR HOME HEALTHCARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356783070
- **Authorized official:** MRS. ZAHRA M. MOHAMED (INTAKE COORDINATOR)
- **Authorized official phone:** (571) 229-0268

## Contact information

- **Practice address:** 4054 RAFT COVE CT, WOODBRIDGE, VA 22193-5870
- **Practice address phone:** (571) 229-0268
- **Mailing address:** 4054 RAFT COVE CT, WOODBRIDGE, VA 22193-5870
- **Mailing address phone:** (571) 229-0268

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | HCO-17979 | VA | Yes |
| 385H00000X | Respite Care | HCO-17979 | VA | — |

## Other

- **Enumeration date:** 07/23/2013
- **Last updated:** 09/27/2016