Healthcare Provider Details

I. General information

NPI: 1922918705
Provider Name (Legal Business Name): VILLAGE CAREGIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 STEWART LN
MONTROSE WV
26283-1201
US

IV. Provider business mailing address

134 STEWART LN
MONTROSE WV
26283-1201
US

V. Phone/Fax

Practice location:
  • Phone: 304-904-2362
  • Fax:
Mailing address:
  • Phone: 304-904-2362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. ADDISYN GRACE WAYBRIGHT
Title or Position: CAREGIVING
Credential: HHA
Phone: 681-481-2053