Healthcare Provider Details
I. General information
NPI: 1346908472
Provider Name (Legal Business Name): CULTURAL HOME HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/06/2021
Last Update Date: 05/18/2022
Certification Date: 05/18/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4317 BONNEY RD STE 2
VIRGINIA BEACH VA
23452-1235
US
IV. Provider business mailing address
4317 BONNEY RD STE 2
VIRGINIA BEACH VA
23452-1235
US
V. Phone/Fax
- Phone: 757-904-1543
- Fax:
- Phone: 757-904-1543
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 376K00000X |
| Taxonomy | Nurse's Aide |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385H00000X |
| Taxonomy | Respite Care |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DEQUINTON
RAMON
BAKER
Title or Position: OWNER
Credential:
Phone: 757-933-0530