Healthcare Provider Details

I. General information

NPI: 1265070858
Provider Name (Legal Business Name): STREAKS ANGELS OF LOVE WITH HELPING HANDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2019
Last Update Date: 12/15/2019
Certification Date: 12/15/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6087 MOORETOWN RD
WILLIAMSBURG VA
23188-1748
US

IV. Provider business mailing address

4542 CEDAR POINT LN
WILLIAMSBURG VA
23188-6908
US

V. Phone/Fax

Practice location:
  • Phone: 757-254-8197
  • Fax:
Mailing address:
  • Phone: 757-291-1917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. CONNIE A SAFEWRIGHT
Title or Position: OWNER
Credential: CNA
Phone: 757-291-1917