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General NPI Number Information
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NPI Number | 1366913931
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Entity Type | Organization
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Legal Business Name | SUN RISEON THE SOUTH HOME CARE & TRANSPORTATION
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Dates
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Enumeration Date | 12/07/2018
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Last Update Date | 12/07/2018
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Provider Practice Location Address
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Address Line | 3000 SOUTH ST
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City | SOUTH CHESTERFIELD
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State | VA
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Zip | 23834-5230
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Country | US
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Telephone | 804-605-7573
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Fax | 804-203-5733
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Provider Business Mailing Address
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Address Line | 3000 SOUTH ST
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City | SOUTH CHESTERFIELD
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State | VA
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Zip | 23834-5230
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Country | US
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Telephone | 804-605-7573
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Fax | 804-203-5733
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Authorized Official
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Title or Position | DIRECTOR OF CLINICAL OPERATION
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Name | MS. MAKESHA NDIAYE
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Credential | OWNER
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Telephone | 804-605-7573
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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 |
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License Number State |
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