Provider Demographics
NPI:1053753640
Name:PATTY'S HOME CARE
Entity type:Organization
Organization Name:PATTY'S HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIKO
Authorized Official - Middle Name:
Authorized Official - Last Name:TSURUTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-359-5275
Mailing Address - Street 1:8300 BOONE BLVD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2626
Mailing Address - Country:US
Mailing Address - Phone:740-359-5275
Mailing Address - Fax:
Practice Address - Street 1:8300 BOONE BLVD
Practice Address - Street 2:SUITE 500
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-2626
Practice Address - Country:US
Practice Address - Phone:740-359-5275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health