Healthcare Provider Details
I. General information
NPI: 1760860852
Provider Name (Legal Business Name): WILLIAMSBURG LANDING HOME HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/11/2015
Last Update Date: 05/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5700 WILLIAMSBURG LANDING DR
WILLIAMSBURG VA
23185-3779
US
IV. Provider business mailing address
5700 WILLIAMSBURG LANDING DR
WILLIAMSBURG VA
23185-3779
US
V. Phone/Fax
- Phone: 757-565-6525
- Fax: 757-565-6551
- Phone: 757-565-6525
- Fax: 757-565-6551
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
NANCY
LOUISE
BARHITE
Title or Position: ADMINISTRATOR
Credential: R.N
Phone: 757-565-6525