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General NPI Number Information
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NPI Number | 1245627330
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Entity Type | Organization
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Legal Business Name | FAMILY LIFELINE
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Dates
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Enumeration Date | 04/16/2015
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Last Update Date | 04/16/2015
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Provider Practice Location Address
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Address Line | 2325 W BROAD ST
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City | RICHMOND
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State | VA
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Zip | 23220-2009
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Country | US
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Telephone | 804-249-5400
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Fax | 804-285-3701
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Provider Business Mailing Address
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Address Line | 2325 W BROAD ST
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City | RICHMOND
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State | VA
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Zip | 23220-2009
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Country | US
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Telephone | 804-249-5400
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Fax | 804-285-3701
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | MS. AMY STRITE
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Credential |
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Telephone | 804-249-5400
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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 | HCO15744
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License Number State | VA
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