Healthcare Provider Details

I. General information

NPI: 1336853001
Provider Name (Legal Business Name): PERFECT TOUCH HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2023
Last Update Date: 02/16/2024
Certification Date: 02/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 GITTINGS ST STE 100D
SUFFOLK VA
23434-6155
US

IV. Provider business mailing address

707 GITTINGS ST STE 100D
SUFFOLK VA
23434-6155
US

V. Phone/Fax

Practice location:
  • Phone: 757-809-1409
  • Fax: 757-809-0107
Mailing address:
  • Phone: 757-803-1409
  • Fax: 757-809-0107

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: KA'DEEM RIDDICK
Title or Position: OWNER
Credential:
Phone: 757-809-1409