Healthcare Provider Details

I. General information

NPI: 1174136030
Provider Name (Legal Business Name): SPENCER & SPARROW HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2020
Last Update Date: 08/28/2020
Certification Date: 08/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 MONTFAIR DR
AMHERST VA
24521-2732
US

IV. Provider business mailing address

PO BOX 74
AMHERST VA
24521-0074
US

V. Phone/Fax

Practice location:
  • Phone: 434-435-8743
  • Fax:
Mailing address:
  • Phone: 434-465-8743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MRS. LAKISHA JONES
Title or Position: CEO
Credential:
Phone: 434-465-8743