Provider Demographics
NPI:1871329813
Name:DYNAMIC CARE SERVICES LLC
Entity type:Organization
Organization Name:DYNAMIC CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MUSTAFA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAHEERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-510-2011
Mailing Address - Street 1:6500 TACK HOUSE TRL
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-4932
Mailing Address - Country:US
Mailing Address - Phone:571-510-2011
Mailing Address - Fax:
Practice Address - Street 1:6500 TACK HOUSE TRL
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20120-4932
Practice Address - Country:US
Practice Address - Phone:571-510-2011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty