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General NPI Number Information
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NPI Number | 1053814483
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Entity Type | Organization
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Legal Business Name | IMPERIAL HOME HEALTHCARE
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Dates
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Enumeration Date | 03/12/2018
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Last Update Date | 03/12/2018
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Provider Practice Location Address
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Address Line | 6040 CAMELLIA DR APT A
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City | SUFFOLK
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State | VA
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Zip | 23435-2298
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Country | US
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Telephone | 202-578-4720
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Fax | 757-257-5993
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Provider Business Mailing Address
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Address Line | 6040 CAMELLIA DR APT A
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City | SUFFOLK
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State | VA
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Zip | 23435-2298
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Country | US
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Telephone | 202-578-4720
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Fax | 757-257-5993
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Authorized Official
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Title or Position | CEO
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Name | RYNESHA KNIGHT
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Credential |
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Telephone | 202-578-4720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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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 | 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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