Healthcare Provider Details

I. General information

NPI: 1306629977
Provider Name (Legal Business Name): VIRGINIA CONSUMER-DIRECTED SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2023
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 TECH CENTER PKWY STE 200-109
NEWPORT NEWS VA
23606-3075
US

IV. Provider business mailing address

700 TECH CENTER PKWY STE 200-109
NEWPORT NEWS VA
23606-3075
US

V. Phone/Fax

Practice location:
  • Phone: 757-949-5666
  • Fax: 757-290-8625
Mailing address:
  • Phone: 757-949-5666
  • Fax: 757-250-8625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. ISAIAH HOBBS
Title or Position: ADMINISTRATOR
Credential: SF
Phone: 757-949-5666