Provider Demographics
NPI:1568347144
Name:DOXA HEALTHCARE AGENCY LLC
Entity type:Organization
Organization Name:DOXA HEALTHCARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING/ CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUCE-TAGOE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:703-919-5815
Mailing Address - Street 1:4216 EVERGREEN LN STE 133
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-3256
Mailing Address - Country:US
Mailing Address - Phone:703-919-5815
Mailing Address - Fax:
Practice Address - Street 1:4216 EVERGREEN LN STE 133
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3256
Practice Address - Country:US
Practice Address - Phone:703-919-5815
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health