# ROSA MYSTICA PROFESSIONAL HOME HEALTH CARE SERVICES LLC

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

## Provider details

- **NPI number:** 1639843949
- **Authorized official:** MS. NKECHI EKE (RN)
- **Authorized official phone:** (682) 227-9815

## Contact information

- **Practice address:** 1200 S COURTHOUSE RD APT 127, ARLINGTON, VA 22204-6258
- **Practice address phone:** (703) 826-9551
- **Mailing address:** 1200 S COURTHOUSE RD APT 127, ARLINGTON, VA 22204-6258
- **Mailing address phone:** (703) 826-9551

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WH0200X | Home Health Registered Nurse | — | NULL | Yes |
| 163WH0200X | Home Health Registered Nurse | — | — | Yes |
| 251E00000X | Home Health Agency | — | NULL | — |

## Other

- **Enumeration date:** 08/02/2021
- **Last updated:** 08/02/2021