=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053121392
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MCPHERSON CARE & GIFTED LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/09/2025
-----------------------------------------------------
Last Update Date | 01/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3386 HOLLAND RD STE 201
-----------------------------------------------------
City | VIRGINIA BEACH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23452-4818
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-405-2648
-----------------------------------------------------
Fax | 757-997-6550
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2076 GREY FOX LN
-----------------------------------------------------
City | VIRGINIA BEACH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23456-5206
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-405-2648
-----------------------------------------------------
Fax | 757-997-6550
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | TAMEIKA JHEANELL MAJETTE
-----------------------------------------------------
Credential | RN, MSN
-----------------------------------------------------
Telephone | 757-405-2648
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 385H00000X
-----------------------------------------------------
Taxonomy Name | Respite Care
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------