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General NPI Number Information
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NPI Number | 1003213885
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Entity Type | Organization
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Legal Business Name | I AM COMPANION HOME CARE, LLC
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Dates
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Enumeration Date | 11/23/2014
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Last Update Date | 11/23/2014
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Provider Practice Location Address
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Address Line | 813 FORREST DR STE 1
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-4513
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Country | US
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Telephone | 757-599-0093
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Fax | 757-599-0095
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Provider Business Mailing Address
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Address Line | 813 FORREST DR STE 1
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-4513
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Country | US
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Telephone | 757-599-0093
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Fax | 757-599-0095
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ALEXIS C CARTER
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Credential |
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Telephone | 757-644-8053
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HCO151232
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License Number State | VA
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