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General NPI Number Information
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NPI Number | 1356656649
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Entity Type | Organization
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Legal Business Name | MESSIAH HEAVENLY HOME CARE
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Dates
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Enumeration Date | 08/11/2010
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Last Update Date | 09/13/2010
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Provider Practice Location Address
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Address Line | 4701 SHORE DR STE 103
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-2893
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Country | US
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Telephone | 757-545-6196
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Fax | 866-554-3602
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Provider Business Mailing Address
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Address Line | 4701 SHORE DR STE 103
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City | VIRGINIA BEACH
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State | VA
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Zip | 23455-2893
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Country | US
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Telephone | 757-545-6196
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Fax | 866-554-3602
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Authorized Official
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Title or Position | AGENT
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Name | VALERIE ABBOTT
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Credential |
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Telephone | 757-718-3964
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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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 | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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