Healthcare Provider Details

I. General information

NPI: 1134571896
Provider Name (Legal Business Name): MRS. MARY'S LOVING ARMS HOME HEALTH CARE LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2016
Last Update Date: 07/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21170 MEDICINE SPRINGS RD
COURTLAND VA
23837-2468
US

IV. Provider business mailing address

601 N MECHANIC ST
FRANKLIN VA
23851-1455
US

V. Phone/Fax

Practice location:
  • Phone: 757-653-8707
  • Fax:
Mailing address:
  • Phone: 757-653-8707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHCO-161476
License Number StateVA

VIII. Authorized Official

Name: WILIAM HIMES
Title or Position: ADMINISTRATOR
Credential:
Phone: 757-653-8707