Healthcare Provider Details

I. General information

NPI: 1629985908
Provider Name (Legal Business Name): ACCESS RESTORATION CREATIVE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 W QUEENS WAY STE G
HAMPTON VA
23669-4075
US

IV. Provider business mailing address

47 W QUEENS WAY STE G
HAMPTON VA
23669-4075
US

V. Phone/Fax

Practice location:
  • Phone: 757-310-9912
  • Fax:
Mailing address:
  • Phone: 757-310-9912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: TARRANCE ERICCO LEAPHART
Title or Position: CEO
Credential: OWNER
Phone: 757-310-9912