| NPI | 1164720140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE JOHNSON Owner 703-220-2082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health (Licence: VA 10L22720) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care (Licence: VA 10L22720) |
| Enumeration Date | 2011-03-01 |
| Last Update Date | 2011-03-01 |