Provider Demographics
NPI:1962539395
Name:HOME HEALTH CONNECTION, INC.
Entity type:Organization
Organization Name:HOME HEALTH CONNECTION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHAHIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:MAFI
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:301-718-0112
Mailing Address - Street 1:12007 SUNRISE VALLEY DR
Mailing Address - Street 2:SUITE 170
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-3479
Mailing Address - Country:US
Mailing Address - Phone:703-684-3799
Mailing Address - Fax:703-860-2519
Practice Address - Street 1:12007 SUNRISE VALLEY DR
Practice Address - Street 2:SUITE 170
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-3479
Practice Address - Country:US
Practice Address - Phone:703-684-3799
Practice Address - Fax:703-860-2519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-07112385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA008773297Medicaid