PAN HOMEHEALTH SUPPORT SERVICES LLC
NPI 1104500123
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Annandale, VA

Q: What is Pan Homehealth Support Services LLC's NPI number?

The NPI number for Pan Homehealth Support Services LLC is 1104500123. It was assigned to this organization in the NPPES registry on June 12, 2023.

Q: What is Pan Homehealth Support Services LLC's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.

Active since June 12, 2023

4201 JOHN MARR DR STE 210, ANNANDALE, VA 22003(301) 437-7749 Get Directions Write a Review

NPPES record last updated: June 12, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Pan Homehealth Support Services Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PAN HOMEHEALTH SUPPORT SERVICES LLC (NPI 1104500123) is a healthcare organization registered as a residential treatment facility, intellectual and/or developmental disabilities in Annandale, Virginia and active in the NPI registry since June 2023. The organization lists Cletus A Fonmedig, Director, as its authorized official.

NPPES Registry Identity

NPI1104500123

Entity TypeOrganization

Primary Taxonomy320600000X

Legal Business NamePAN HOMEHEALTH SUPPORT SERVICES LLC

Location Address4201 JOHN MARR DR STE 210Annandale, VA 22003-3204

Mailing Address4201 John Marr Dr Ste 210Annandale, VA 22003-3204 · (301) 437-7749

Phone(301) 437-7749

Organization SubpartNo

Authorized OfficialCletus A FonmedigDirector · (301) 437-7749

Enumeration DateJune 12, 2023

NPPES CertifiedJune 10, 2023

✔ NPI 1104500123 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities

Taxonomy Code320600000X

Definition

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

4201 JOHN MARR DR STE 210, Annandale, VA 22003

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pan Homehealth Support Services LLC's NPI number?

The NPI number for Pan Homehealth Support Services LLC is 1104500123. It was assigned to this organization in the NPPES registry on June 12, 2023.

Where is Pan Homehealth Support Services LLC located?

Pan Homehealth Support Services LLC is located at 4201 John Marr Dr Ste 210, Annandale, VA 22003. The listed phone number is (301) 437-7749.

What is Pan Homehealth Support Services LLC's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320600000X.

When was this NPI record last updated?

The NPPES record for Pan Homehealth Support Services LLC was last updated on June 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.