Organization
THREE FINGER JACK LLC
Active
Other names
Executive Home Care of Manassas
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN MCBROOM (OWNER OPERATOR)
(540) 424-3991
Entity
Organization
Contact information
Practice address
10432 BALLS FORD RD STE 300, MANASSAS, VA 20109-2517
(703) 936-5545
Mailing address
10432 BALLS FORD RD STE 300, MANASSAS, VA 20109-2517
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
07/01/2025
Last updated
07/23/2025
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