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Organization

AMENDED HOME HEALTH CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RAJIB HOQ (ADMINISTRATOR)
(571) 356-1538
Entity
Organization

Contact information

Practice address
2658 COCKERILL FARM LN, HERNDON, VA 20171-2689
(571) 356-1538
Mailing address
2658 COCKERILL FARM LN, HERNDON, VA 20171-2689
(571) 356-1538

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
3747P1801X
Personal Care Attendant
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care

Other

Enumeration date
09/24/2024
Last updated
11/27/2024
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