Healthcare Provider Details

I. General information

NPI: 1629463971
Provider Name (Legal Business Name): DEBORAH & CO COMMUNITY OUTREACH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2015
Last Update Date: 04/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

538 APPALOOSA TRL
CHESAPEAKE VA
23323-1000
US

IV. Provider business mailing address

538 APPALOOSA TRL
CHESAPEAKE VA
23323-1000
US

V. Phone/Fax

Practice location:
  • Phone: 757-270-1816
  • Fax:
Mailing address:
  • Phone: 757-270-1816
  • 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 Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. TAMEKA DEBORAH FARRINGTON
Title or Position: CEO
Credential: MBA,QMHP
Phone: 757-270-1816