Healthcare Provider Details

I. General information

NPI: 1144869660
Provider Name (Legal Business Name): YOUNIVERSAL HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/01/2020
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 LIVE OAK DR STE 27
CHESAPEAKE VA
23320-2600
US

IV. Provider business mailing address

809 LIVE OAK DR STE 27
CHESAPEAKE VA
23320-2600
US

V. Phone/Fax

Practice location:
  • Phone: 757-904-1119
  • Fax: 757-299-7836
Mailing address:
  • Phone: 757-904-1119
  • Fax: 757-299-7836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MS. IESHA ANDREWS
Title or Position: HEALTHCARE DIRECTOR
Credential: BSN, RN
Phone: 757-904-1119