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General NPI Number Information
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NPI Number | 1093165383
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Entity Type | Organization
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Legal Business Name | NURSE OF HOPE
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Dates
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Enumeration Date | 06/16/2016
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Last Update Date | 06/16/2016
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Provider Practice Location Address
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Address Line | 1323 GILMER AVE NW
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City | ROANOKE
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State | VA
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Zip | 24017-5636
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Country | US
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Telephone | 540-344-0500
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Fax | 540-344-0505
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Provider Business Mailing Address
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Address Line | 1323 GILMER AVE NW
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City | ROANOKE
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State | VA
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Zip | 24017-5636
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Country | US
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Telephone | 540-344-0500
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Fax | 540-344-0505
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Authorized Official
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Title or Position | ONWER
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Name | MRS. SHEMEKA HOUGH
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Credential |
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Telephone | 540-344-0500
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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 | 1401117434
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License Number State | VA
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