Healthcare Provider Details

I. General information

NPI: 1770517369
Provider Name (Legal Business Name): IN HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 01/23/2022
Certification Date: 01/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5041 CORPORATE WOODS DR SUITE 200
VIRGINIA BEACH VA
23462-4375
US

IV. Provider business mailing address

333 N SUMMIT ST ATTN: DEAN SHIPMAN
TOLEDO OH
43604-2635
US

V. Phone/Fax

Practice location:
  • Phone: 757-490-9609
  • Fax: 757-490-8711
Mailing address:
  • Phone: 419-254-7841
  • Fax: 419-252-6448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number0524-15
License Number StateVA

VIII. Authorized Official

Name: MR. MARTIN D ALLEN
Title or Position: DIRECTOR
Credential:
Phone: 419-252-5734