# VIDA IN HOME CARE LLC

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

## Provider details

- **NPI number:** 1932814308
- **Authorized official:** MR. MICHEL CHRISTIAN IENCO (OFFICE MANAGER)
- **Authorized official phone:** (703) 899-8997

## Contact information

- **Practice address:** 3 CROSSWOOD PL, STAFFORD, VA 22554-7839
- **Practice address phone:** (703) 899-8997
- **Practice address fax:** (540) 720-5356
- **Mailing address:** 524 GARRISONVILLE RD, PO BOX 151, GARRISONVILLE, VA 22463-9998
- **Mailing address phone:** (703) 899-8997
- **Mailing address fax:** (540) 720-5356

## Taxonomy

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

## Other

- **Enumeration date:** 01/19/2023
- **Last updated:** 01/19/2023