Healthcare Provider Details

I. General information

NPI: 1790165645
Provider Name (Legal Business Name): CLIENTS FIRST HOME HEALTH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2015
Last Update Date: 06/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 MADISON PLZ STE 202
CHESAPEAKE VA
23320-5166
US

IV. Provider business mailing address

1108 MADISON PLZ STE 202
CHESAPEAKE VA
23320-5166
US

V. Phone/Fax

Practice location:
  • Phone: 757-512-5565
  • Fax:
Mailing address:
  • Phone: 757-512-5565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number151097
License Number StateVA

VIII. Authorized Official

Name: MARK MITCHELL
Title or Position: ADMINISTRATOR
Credential:
Phone: 757-512-5565