Healthcare Provider Details

I. General information

NPI: 1558901231
Provider Name (Legal Business Name): SJ HANDS ON HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2020
Last Update Date: 08/15/2024
Certification Date: 08/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1129 LOUISA ST
NORFOLK VA
23523-1417
US

IV. Provider business mailing address

900 GRANBY ST STE 205
NORFOLK VA
23510-2503
US

V. Phone/Fax

Practice location:
  • Phone: 757-386-0805
  • Fax:
Mailing address:
  • Phone: 757-756-5253
  • 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 Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MS. JAZMINE SPRUILL
Title or Position: MANAGING MEMBER
Credential: PCA
Phone: 757-756-5253