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General NPI Number Information
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NPI Number | 1003705633
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Entity Type | Organization
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Legal Business Name | PONDEROSA HOME HEALTH CARE INC.
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 3449 SANDY POINT RD
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City | KINSALE
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State | VA
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Zip | 22488-2535
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Country | US
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Telephone | 804-472-7525
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Fax |
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Provider Business Mailing Address
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Address Line | 3449 SANDY POINT RD
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City | KINSALE
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State | VA
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Zip | 22488-2535
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Country | US
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Telephone | 804-472-7525
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. TINIKA ANDAWANDA BALL
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Credential |
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Telephone | 804-472-7525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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