Green Home Care Agency, LLC

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

License

372600000X Issued in VA

Legal business name

GREEN HOME CARE AGENCY, LLC

Practice address

2562 Miranda CT
Woodbridge, VA 22191-5175

Phone

(703) 439-7382

NPI assigned

Jan 21, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Khalidah A SediqNPI 1750779195

Title

Founder/Ceo

Phone

(703) 439-7382

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Khalidah Sediq

  • Adult Companion
  • Woodbridge, VA
  • NPI 1750779195
  NPD (past) Authorized official

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

{
    "created_epoch": "1421798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421798400000",
    "number": "1912396458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2562 MIRANDA CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221915175",
            "telephone_number": "703-439-7382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2562 MIRANDA CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221915175",
            "telephone_number": "703-439-7382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN HOME CARE AGENCY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-21",
        "last_updated": "2015-01-21",
        "status": "A",
        "authorized_official_last_name": "SEDIQ",
        "authorized_official_first_name": "KHALIDAH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "FOUNDER/CEO",
        "authorized_official_telephone_number": "703-439-7382",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "VA",
            "license": "372600000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRS",
            "identifier": "47-2855057",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Caitlin Green
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• Nursing Care Agency in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Nursing Care Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; 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.