Salvation Academy Health Care & Security Services LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

HCO-14940 Issued in VA

Legal business name

SALVATION ACADEMY HEALTH CARE & SECURITY SERVICES LLC

Doing business as

Salvation Academy Home Health Agency

Practice address

4613 Pinecrest Office Park Dr
Suite G
Alexandria, VA 22312-1442

Phone

(703) 763-1115

Fax

(703) 226-3328

NPI assigned

Dec 20, 2014

Last updated

Dec 20, 2014By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Brima Bob Deen, BA, ADBS, GMB CHI

Title

President

Phone

(703) 763-1115

Specialties & licenses 1

Addresses

Other names 1

• SALVATION ACADEMY HOME HEALTH AGENCY Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1419033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419033600000",
    "number": "1700284999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4613 PINECREST OFFICE PARK DR",
            "address_2": "SUITE G",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223121442",
            "telephone_number": "703-763-1115",
            "fax_number": "703-226-3328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4613 PINECREST OFFICE PARK DR",
            "address_2": "SUITE G",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223121442",
            "telephone_number": "703-763-1115",
            "fax_number": "703-226-3328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALVATION ACADEMY HEALTH CARE & SECURITY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-20",
        "last_updated": "2014-12-20",
        "status": "A",
        "authorized_official_last_name": "DEEN",
        "authorized_official_first_name": "BRIMA",
        "authorized_official_middle_name": "BOB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-763-1115",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BA, ADBS, GMB CHI"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "VA",
            "license": "HCO-14940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SALVATION ACADEMY HOME HEALTH AGENCY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Taylor Sambucci, MS, RDN
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• Home Health Agency in Alexandria, VA
• Providers in Alexandria, VA by specialty
• Home Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.