# MYPOTENTIAL VIRGINIA, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NATIONAL LUTERAN HOME FOR THE AGED, INC.
- **Other names:** myPotential at Home
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1528449055
- **Legal business name:** NATIONAL LUTERAN HOME FOR THE AGED, INC.
- **Authorized official:** MR. MICHAEL JOSEPH BRADY SR. CPA (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (301) 354-2714

## Contact information

- **Practice address:** 320 WESTSIDE STATION DR, WINCHESTER, VA 22601-2839
- **Practice address phone:** (540) 450-0343
- **Practice address fax:** (540) 723-0858
- **Mailing address:** 2301 RESEARCH BLVD, SUITE 310, ROCKVILLE, MD 20850-3204
- **Mailing address phone:** (301) 354-2710

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | HCO-151094 | VA | Yes |

## Other

- **Enumeration date:** 06/10/2015
- **Last updated:** 06/10/2015