Healthcare Provider Details

I. General information

NPI: 1508612185
Provider Name (Legal Business Name): BEAUTIFUL A&T HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2024
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3276 ACADEMY AVE STE 14
PORTSMOUTH VA
23703-3203
US

IV. Provider business mailing address

3276 ACADEMY AVE STE 14
PORTSMOUTH VA
23703-3203
US

V. Phone/Fax

Practice location:
  • Phone: 757-239-9717
  • Fax:
Mailing address:
  • Phone: 757-239-9717
  • 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: TAMEKA BLUNT
Title or Position: OWNER
Credential:
Phone: 757-239-9717