Healthcare Provider Details

I. General information

NPI: 1669095725
Provider Name (Legal Business Name): CYNTHIA'S VILLAGE HOME AND HEALTHCARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2020
Last Update Date: 05/26/2020
Certification Date: 05/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 TREEBARK PL
HAMPTON VA
23666-2179
US

IV. Provider business mailing address

8 TREEBARK PL
HAMPTON VA
23666-2179
US

V. Phone/Fax

Practice location:
  • Phone: 757-327-9277
  • Fax:
Mailing address:
  • Phone: 757-327-9277
  • Fax:

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 Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: JAMES EDWARD SYLVESTER
Title or Position: CEO
Credential:
Phone: 229-518-8898