NPIMap

Organization Active NPI

In-Home Supportive Service

  • Home Health Agency
  • Woodbridge, VA
National Provider Identifier
1962196014
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
IN-HOME SUPPORTIVE SERVICE
Practice address
3526 Nexus CT
Woodbridge, VA 22192-4437
Phone
(510) 677-8671
NPI assigned
Jun 2, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Authorized official

Name
Lida NabNPI 1881387132
Title
Owner
Phone
(510) 677-8671

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary
Attendant Care ProviderGroup: 193200000X MULTI-SPECIALTY GROUP 3747A0650X

Addresses

Primary practice location

3526 Nexus CT
Woodbridge, VA 22192-4437

Mailing address

3526 Nexus CT
Woodbridge, VA 22192-4437

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1685664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1962196014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3526 NEXUS CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3526 NEXUS CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221924437",
            "telephone_number": "510-677-8671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN-HOME SUPPORTIVE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-02",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "NAB",
        "authorized_official_first_name": "LIDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-677-8671"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.