Provider Demographics
NPI:1699339283
Name:AW HOME CARE AGENCY LLC
Entity type:Organization
Organization Name:AW HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN / ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALHASSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KABIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-346-4628
Mailing Address - Street 1:5680 KING CENTRE DR STE 600
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315-5755
Mailing Address - Country:US
Mailing Address - Phone:703-346-4638
Mailing Address - Fax:
Practice Address - Street 1:5680 KING CENTRE DR STE 600
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22315-5755
Practice Address - Country:US
Practice Address - Phone:703-346-4638
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-29
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health