Healthcare Provider Details

I. General information

NPI: 1710690888
Provider Name (Legal Business Name): YOUR FAMILY IS FAMILY HOME HEALTHCARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2023
Last Update Date: 01/03/2023
Certification Date: 01/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3640 S PLAZA TRL STE 204A
VIRGINIA BEACH VA
23452-3363
US

IV. Provider business mailing address

3640 S PLAZA TRL STE 204A
VIRGINIA BEACH VA
23452-3363
US

V. Phone/Fax

Practice location:
  • Phone: 757-938-8126
  • Fax: 757-222-8928
Mailing address:
  • Phone: 757-938-8126
  • Fax: 757-222-8928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: LASHAUN EDMONDS
Title or Position: ADMINISTRATOR
Credential:
Phone: 757-938-8126