1487659652 NPI number — AMERICAN HEALTH HOME CARE GROUP, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487659652 NPI number — AMERICAN HEALTH HOME CARE GROUP, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMERICAN HEALTH HOME CARE GROUP, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
AMERICAN HEALTH CARE PROFESSIONALS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487659652
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
120 BEULAH RD NE
Provider Second Line Business Mailing Address:
STE 201
Provider Business Mailing Address City Name:
VIENNA
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22180-4745
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-319-3801
Provider Business Mailing Address Fax Number:
703-319-3805

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120 BEULAH RD NE
Provider Second Line Business Practice Location Address:
STE 201
Provider Business Practice Location Address City Name:
VIENNA
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22180-4745
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-319-3801
Provider Business Practice Location Address Fax Number:
703-319-3805
Provider Enumeration Date:
06/15/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
TAYLOR
Authorized Official First Name:
CLISHIA
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
703-319-3801

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  497536 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 491561 . This is a "HOSPICE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".