Organization
PROVIDENCE HOME HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CYNTHIA A BARDWELL (PRESIDENT)
(703) 705-2112
Entity
Organization
Contact information
Practice address
5568 GENERAL WASHINGTON DR STE A201, ALEXANDRIA, VA 22312-2465
(571) 295-6991
(877) 852-6352
Mailing address
5568 GENERAL WASHINGTON DR STE A201, ALEXANDRIA, VA 22312-2465
(703) 705-2112
(877) 852-6352
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
—
164W00000X
Licensed Practical Nurse
—
—
171M00000X
Case Manager/Care Coordinator
—
—
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
—
—
363L00000X
Nurse Practitioner
—
—
3747A0650X
Attendant Care Provider
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
10/19/2020
Last updated
10/19/2020
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