Provider Demographics
NPI:1912320581
Name:AA FAMILY HOMECARE SERVICE INC
Entity type:Organization
Organization Name:AA FAMILY HOMECARE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:N
Authorized Official - Last Name:ESSIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-241-1025
Mailing Address - Street 1:7061 BROOKFIELD PLZ
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-2915
Mailing Address - Country:US
Mailing Address - Phone:703-752-0539
Mailing Address - Fax:
Practice Address - Street 1:7061 BROOKFIELD PLZ
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-2915
Practice Address - Country:US
Practice Address - Phone:703-752-0539
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-01
Last Update Date:2014-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1356187251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health