Healthcare Provider Details

I. General information

NPI: 1215006242
Provider Name (Legal Business Name): CARE ADVANTAGE PLUS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 05/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2788 HYDRAULIC RD SUITE 2
CHARLOTTESVILLE VA
22901
US

IV. Provider business mailing address

10041 MIDLOTHIAN TPKE
RICHMOND VA
23235-4815
US

V. Phone/Fax

Practice location:
  • Phone: 434-973-2000
  • Fax: 434-973-1420
Mailing address:
  • Phone: 804-323-9464
  • Fax: 804-330-3156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHCO-0776
License Number StateVA

VIII. Authorized Official

Name: TIMOTHY HANOLD
Title or Position: CEO
Credential:
Phone: 804-323-9464