Pan Homehealth Support Services LLC
NPI 1104500123 · Intellectual and/or Developmental Disabilities Residential Treatment Facility · Annandale, VA
Pan Homehealth Support Services LLC is a Intellectual and/or Developmental Disabilities Residential Treatment Facility organization in Annandale, VA (NPI 1104500123).
Provider details
- NPI number
- 1104500123
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Cletus Fonmedig, Director(301) 437-7749
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2023-06-12
- Last updated
- 2023-06-12
- Certified
- 2023-06-10
Frequently asked questions
- What is Pan Homehealth Support Services LLC's NPI number?
- Pan Homehealth Support Services LLC's National Provider Identifier (NPI) is 1104500123, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Pan Homehealth Support Services LLC?
- Pan Homehealth Support Services LLC is classified in the NPPES registry as Intellectual and/or Developmental Disabilities Residential Treatment Facility (Residential Treatment Facilities).
- Where is Pan Homehealth Support Services LLC located?
- Pan Homehealth Support Services LLC's practice location on file with NPPES is 4201 John Marr Dr Ste 210, Annandale, VA 22003-3204.
- What is Pan Homehealth Support Services LLC's phone number?
- The practice phone number listed in the NPPES registry for Pan Homehealth Support Services LLC is (301) 437-7749.
- Who is the authorized official for Pan Homehealth Support Services LLC?
- The authorized official listed on Pan Homehealth Support Services LLC's NPPES record is Cletus Fonmedig, Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Pan Homehealth Support Services LLC's NPI active?
- Yes — Pan Homehealth Support Services LLC's NPI (1104500123) is active in the NPPES registry as of the last update on 2023-06-12.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.