Provider Demographics
NPI:1417790106
Name:DESIRED HOMECARE AND THERAPEUTIC SERVICES LLC
Entity type:Organization
Organization Name:DESIRED HOMECARE AND THERAPEUTIC SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHEBORA
Authorized Official - Middle Name:A
Authorized Official - Last Name:KAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-338-6539
Mailing Address - Street 1:5290 SHAWNEE RD STE 200-9
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22312-2381
Mailing Address - Country:US
Mailing Address - Phone:571-338-6539
Mailing Address - Fax:
Practice Address - Street 1:5290 SHAWNEE RD STE 200-9
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22312-2381
Practice Address - Country:US
Practice Address - Phone:571-338-6539
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-18
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health