1689060469 NPI number — DIGNITY-CARE HOME HEALTH SERVICES, LLC

Table of content: (NPI 1689060469)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689060469 NPI number — DIGNITY-CARE HOME HEALTH SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DIGNITY-CARE HOME HEALTH SERVICES, LLC
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:
Provider Other Organization Name Type Code:
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:
1689060469
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/26/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9645 FRANKLIN WOODS PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LORTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22079-2344
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-459-5645
Provider Business Mailing Address Fax Number:
703-372-2122

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7630 LITTLE RIVER TURN PIKE, ANNANDALE II
Provider Second Line Business Practice Location Address:
SUITE 316
Provider Business Practice Location Address City Name:
ANNANDALE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
571-347-7361
Provider Business Practice Location Address Fax Number:
571-347-7637
Provider Enumeration Date:
04/08/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BANGURA
Authorized Official First Name:
RABIATU
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
703-459-5645

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251B00000X , with the licence number: HCO151258 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: HCO151258 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251F00000X , with the licence number: HCO151258 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251J00000X , with the licence number: HCO151258 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 372600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3747A0650X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 385H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: HCO231272 . This is a "VA DEPARTMENT OF HEALTH" identifier . This identifiers is of the category "OTHER".