Provider Demographics
NPI:1124433453
Name:KIND-CARE
Entity type:Organization
Organization Name:KIND-CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALT ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SHARMARK
Authorized Official - Middle Name:MOHAMUD
Authorized Official - Last Name:ISMAIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-865-9664
Mailing Address - Street 1:13800 COPPERMINE RD
Mailing Address - Street 2:STE 148
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20171-6163
Mailing Address - Country:US
Mailing Address - Phone:866-769-6746
Mailing Address - Fax:703-935-2438
Practice Address - Street 1:13800 COPPERMINE RD
Practice Address - Street 2:STE 148
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171-6163
Practice Address - Country:US
Practice Address - Phone:866-769-6746
Practice Address - Fax:703-935-2438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-25
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-145943747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty