Healthcare Provider Details
I. General information
NPI: 1952547614
Provider Name (Legal Business Name): DUE SEASON HOSPICE AND HOMECARE AGENCY, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/31/2008
Last Update Date: 12/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3806 CHAMBERLAYNE AVE STE 18A
RICHMOND VA
23227-4110
US
IV. Provider business mailing address
3806 CHAMBERLAYNE AVE STE 18A
RICHMOND VA
23227-4110
US
V. Phone/Fax
- Phone: 804-400-6479
- Fax:
- Phone: 804-400-6479
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251T00000X |
| Taxonomy | PACE Provider Organization |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LESA
ANN
JACOBS
Title or Position: CLINICAL DIRECTOR
Credential: RN
Phone: 910-734-0949