Healthcare Provider Details

I. General information

NPI: 1275784191
Provider Name (Legal Business Name): PERSONAL TOUCH HOME CARE OF VA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2008
Last Update Date: 10/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21204 NORTH BAYSIDE ROAD
CHERITON VA
23316
US

IV. Provider business mailing address

22215 NORTHERN BLVD 3RD FLOOR
BAYSIDE NY
11361-3603
US

V. Phone/Fax

Practice location:
  • Phone: 757-331-1327
  • Fax: 757-331-2317
Mailing address:
  • Phone: 718-468-4747
  • Fax: 718-264-5834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LORIGAY LASKIN
Title or Position: CONTRACT MANAGER
Credential:
Phone: 718-468-4747