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General NPI Number Information
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NPI Number | 1023894581
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Entity Type | Organization
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Legal Business Name | IN-HOME SUPPORT SERVICES OF VIRGINIA LLC
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Dates
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Enumeration Date | 08/31/2023
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Last Update Date | 08/31/2023
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Provider Practice Location Address
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Address Line | 150 W WASHINGTON ST STE D
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City | SUFFOLK
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State | VA
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Zip | 23434-5272
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Country | US
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Telephone | 757-339-2072
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Fax | 757-539-7228
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Provider Business Mailing Address
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Address Line | 150 W WASHINGTON ST STE D
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City | SUFFOLK
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State | VA
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Zip | 23434-5272
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Country | US
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Telephone | 757-339-2072
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Fax | 757-539-7228
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Authorized Official
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Title or Position | QDDP
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Name | MR. BILLE VIRZELL
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Credential |
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Telephone | 757-339-2072
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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