Organization
BLUE HEART LLC
Active
Other names
TLC Health Services LLC
Organization subpart
No
Provider details
NPI number
Authorized official
SYED SUHAIB ASIF SHAH (ADMINISTRATOR)
(703) 606-7829
Entity
Organization
Contact information
Practice address
3022 JAVIER RD, SUITE 104A, FAIRFAX, VA 22031-4645
(703) 646-1531
Mailing address
3022 JAVIER RD, SUITE 104A, FAIRFAX, VA 22031-4645
(703) 646-1531
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HCO-171537
VA
Other
Enumeration date
11/25/2016
Last updated
11/25/2016
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