Healthcare Provider Details

I. General information

NPI: 1235989567
Provider Name (Legal Business Name): HEALING HANDS ADULT DAY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2024
Last Update Date: 03/27/2024
Certification Date: 03/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16520 GOODES BRIDGE RD
AMELIA COURT HOUSE VA
23002-4822
US

IV. Provider business mailing address

16520 GOODES BRIDGE RD
AMELIA COURT HOUSE VA
23002-4822
US

V. Phone/Fax

Practice location:
  • Phone: 804-389-3847
  • Fax: 804-561-1757
Mailing address:
  • Phone: 804-389-3847
  • Fax: 804-561-1757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KESHIA STEPHENS
Title or Position: OWNER
Credential:
Phone: 804-389-3847