Healthcare Provider Details

I. General information

NPI: 1306605191
Provider Name (Legal Business Name): ENCHANTED HANDS HOME HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2024
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4217 HIGH TIDE WAY
CHESAPEAKE VA
23321-3349
US

IV. Provider business mailing address

4217 HIGH TIDE WAY
CHESAPEAKE VA
23321-3349
US

V. Phone/Fax

Practice location:
  • Phone: 757-751-3824
  • Fax:
Mailing address:
  • Phone: 757-610-1832
  • Fax: 757-998-8250

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 Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: LATOYA BURDEN
Title or Position: OWNER
Credential:
Phone: 757-751-3824