Provider Demographics
NPI:1871140640
Name:COMPANION CARE SOLUTIONS OF NOVA, LLC
Entity type:Organization
Organization Name:COMPANION CARE SOLUTIONS OF NOVA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIVISION PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-642-6103
Mailing Address - Street 1:5350 SHAWNEE RD STE 360
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22312-2318
Mailing Address - Country:US
Mailing Address - Phone:703-642-6103
Mailing Address - Fax:
Practice Address - Street 1:5350 SHAWNEE RD STE 360
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22312-2318
Practice Address - Country:US
Practice Address - Phone:703-642-6103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health