Organization
INDEPENDENT LIVING HOME CARE L. L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA GREEN (OWNER/VP)
(267) 252-1119
Entity
Organization
Contact information
Practice address
6115 MANTLE RD, BURKE, VA 22015-3807
(267) 252-1119
Mailing address
6115 MANTLE RD, BURKE, VA 22015-3807
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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