Provider Demographics
NPI:1861627754
Name:ACTION HOME HEALTH AGENCY LLC
Entity type:Organization
Organization Name:ACTION HOME HEALTH AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTWI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-644-6655
Mailing Address - Street 1:6116 ROLLING RD STE 206A
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22152-1524
Mailing Address - Country:US
Mailing Address - Phone:703-644-6655
Mailing Address - Fax:703-644-1406
Practice Address - Street 1:6116 ROLLING RD STE 206A
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-1524
Practice Address - Country:US
Practice Address - Phone:703-644-6655
Practice Address - Fax:703-644-1406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-20
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-09572251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health