Healthcare Provider Details
I. General information
NPI: 1922742758
Provider Name (Legal Business Name): CARE ADVANTAGE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/27/2022
Last Update Date: 04/27/2022
Certification Date: 04/27/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4215 EVERGREEN LN
ANNANDALE VA
22003-3210
US
IV. Provider business mailing address
10041 MIDLOTHIAN TPKE
NORTH CHESTERFIELD VA
23235-4815
US
V. Phone/Fax
- Phone: 703-649-4271
- Fax:
- Phone: 804-323-9464
- Fax: 804-330-3156
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ASHLEY
ROYSTER
Title or Position: SENIOR MANAGER OF ACCOUNTING
Credential:
Phone: 804-323-9464