Healthcare Provider Details

I. General information

NPI: 1326551862
Provider Name (Legal Business Name): CONNANN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2017
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9512 IRON BRIDGE RD STE 200
CHESTERFIELD VA
23832-6458
US

IV. Provider business mailing address

9512 IRON BRIDGE RD STE 200
CHESTERFIELD VA
23832-6458
US

V. Phone/Fax

Practice location:
  • Phone: 804-410-1228
  • Fax: 804-410-1228
Mailing address:
  • Phone: 804-410-1228
  • Fax: 804-410-1228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: TERESA PAIGE BRILHART
Title or Position: OWNER/DIRECTOR
Credential:
Phone: 804-410-1228