Provider Demographics
NPI:1548661234
Name:AMAZING LIVING HOME HEALTH SERVICES LLC
Entity type:Organization
Organization Name:AMAZING LIVING HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIJA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUPEMBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-842-9993
Mailing Address - Street 1:2841 HARTLAND RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043-3500
Mailing Address - Country:US
Mailing Address - Phone:703-842-9993
Mailing Address - Fax:
Practice Address - Street 1:2841 HARTLAND RD
Practice Address - Street 2:SUITE 200
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043-3500
Practice Address - Country:US
Practice Address - Phone:703-842-9993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-12
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health