Organization
MONTCLAIR HOME HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ZAHRA M. MOHAMED (INTAKE COORDINATOR)
(571) 229-0268
Entity
Organization
Contact information
Practice address
4054 RAFT COVE CT, WOODBRIDGE, VA 22193-5870
(571) 229-0268
Mailing address
4054 RAFT COVE CT, WOODBRIDGE, VA 22193-5870
(571) 229-0268
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HCO-17979
VA
385H00000X
Respite Care
HCO-17979
VA
Other
Enumeration date
07/23/2013
Last updated
09/27/2016
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