Healthcare Provider Details

I. General information

NPI: 1861178022
Provider Name (Legal Business Name): CLOYD HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2023
Last Update Date: 12/26/2024
Certification Date: 12/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 BELAIRE AVE STE 2102073
CHESAPEAKE VA
23320-4783
US

IV. Provider business mailing address

555 BELAIRE AVE STE 2102073
CHESAPEAKE VA
23320-4783
US

V. Phone/Fax

Practice location:
  • Phone: 804-216-0407
  • Fax:
Mailing address:
  • Phone: 757-780-8909
  • Fax: 757-522-1844

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. YASMIN NIXON
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 804-216-0407