Provider Demographics
NPI:1063749554
Name:HOME LINK CARE, LLC
Entity type:Organization
Organization Name:HOME LINK CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:NIKITA
Authorized Official - Middle Name:
Authorized Official - Last Name:FEDOROV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-349-2113
Mailing Address - Street 1:2110 GALLOWS RD STE C1
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3962
Mailing Address - Country:US
Mailing Address - Phone:703-349-2113
Mailing Address - Fax:703-995-0621
Practice Address - Street 1:2110 GALLOWS RD STE C1
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3962
Practice Address - Country:US
Practice Address - Phone:703-349-2113
Practice Address - Fax:703-995-0621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-04
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health