Healthcare Provider Details

I. General information

NPI: 1588126825
Provider Name (Legal Business Name): ISAIAH HOBBS SERVICES FACILITATOR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2019
Last Update Date: 06/22/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 TECH CENTER PKWY STE 200-245
NEWPORT NEWS VA
23606-3075
US

IV. Provider business mailing address

700 TECH CENTER PKWY STE 200-245
NEWPORT NEWS VA
23606-3075
US

V. Phone/Fax

Practice location:
  • Phone: 757-602-0264
  • Fax: 757-901-4191
Mailing address:
  • Phone: 757-602-0264
  • Fax: 757-901-4191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: