Healthcare Provider Details

I. General information

NPI: 1548984115
Provider Name (Legal Business Name): PLEASANTLY SURPRISED COMPANY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2022
Last Update Date: 10/24/2022
Certification Date: 10/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2714 BUILD AMERICA DR
HAMPTON VA
23666-3225
US

IV. Provider business mailing address

2714 BUILD AMERICA DR
HAMPTON VA
23666-3225
US

V. Phone/Fax

Practice location:
  • Phone: 757-224-1923
  • Fax:
Mailing address:
  • Phone: 757-224-1923
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JANICE POWELL
Title or Position: PRESIDENT
Credential:
Phone: 757-814-0665