Independent Living Home Care L. L.C.

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

INDEPENDENT LIVING HOME CARE L. L.C.

Practice address

6115 Mantle Rd
Burke, VA 22015-3807

Phone

(267) 252-1119

NPI assigned

Aug 17, 2020

Organization subpart

No

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

Authorized official

Name

Alicia Green

Title

Owner/VP

Phone

(267) 252-1119

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597622400000",
    "number": "1861004491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6115 MANTLE RD",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220153807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6115 MANTLE RD",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220153807",
            "telephone_number": "267-252-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT LIVING HOME CARE L. L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-17",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_title_or_position": "OWNER/VP",
        "authorized_official_telephone_number": "267-252-1119"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Hutson, PSY.D
• Marie Phuong Huynh, M.D.
• Ignite Developmental Solutions, LLC
• Ke Bin Im
• Rana Iman, O.D.
• Julie Aldes Isaacs, LCSW
• Farnaz Jabbari, DDS
• Jack a Merenda, Psy.D., Inc.
• Lina Jameel, DDS
• James L Gyuricza DDS PC

• In Home Supportive Care Agency in Burke, VA
• Providers in Burke, VA by specialty
• In Home Supportive Care Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.