=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134096902
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CAREQUEST SUPPORT INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/17/2025
-----------------------------------------------------
Last Update Date | 10/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 214 E GRACE ST STE A
-----------------------------------------------------
City | RICHMOND
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23219-1788
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-255-8860
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1021 EDEN WAY N STE 118
-----------------------------------------------------
City | CHESAPEAKE
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23320-2776
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-255-8860
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | LATRICE LITTLE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 804-300-1444
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251B00000X
-----------------------------------------------------
Taxonomy Name | Case Management Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------