Provider Demographics
NPI:1871295949
Name:AGING IN PLACE CAREGIVING SERVICES
Entity type:Organization
Organization Name:AGING IN PLACE CAREGIVING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:DR
Authorized Official - First Name:FONYA
Authorized Official - Middle Name:C
Authorized Official - Last Name:ATABONG
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:734-218-5001
Mailing Address - Street 1:15000 POTOMAC TOWN PL STE 100-147
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-6586
Mailing Address - Country:US
Mailing Address - Phone:734-218-5001
Mailing Address - Fax:
Practice Address - Street 1:6223 GLEN WOOD LOOP
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20112-8871
Practice Address - Country:US
Practice Address - Phone:571-762-0189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251J00000XAgenciesNursing Care
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No385H00000XRespite Care FacilityRespite Care