Healthcare Provider Details

I. General information

NPI: 1790175222
Provider Name (Legal Business Name): CENTRAL VA. COMPANIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2015
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5187 OLD WARWICK RD
RICHMOND VA
23224-2912
US

IV. Provider business mailing address

5187 OLD WARWICK RD
RICHMOND VA
23224-2912
US

V. Phone/Fax

Practice location:
  • Phone: 804-625-1130
  • Fax:
Mailing address:
  • Phone: 804-625-1130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. MARGARET ARCHER
Title or Position: OWNER
Credential:
Phone: 804-625-1130