Healthcare Provider Details

I. General information

NPI: 1609684992
Provider Name (Legal Business Name): A KING ELITE HOME HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2024
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 MUNDEN AVE
NORFOLK VA
23505-2708
US

IV. Provider business mailing address

455 MUNDEN AVE
NORFOLK VA
23505-2708
US

V. Phone/Fax

Practice location:
  • Phone: 757-309-1051
  • Fax:
Mailing address:
  • Phone: 757-309-1051
  • 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: AYEISHA KING
Title or Position: OWNER
Credential:
Phone: 757-309-1051