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General NPI Number Information
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NPI Number | 1376524710
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Entity Type | Organization
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Legal Business Name | CARE ADVANTAGE SKILLED-RICHMOND, LLC
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Dates
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Enumeration Date | 11/11/2005
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Last Update Date | 04/24/2024
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Provider Practice Location Address
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Address Line | 10043 MIDLOTHIAN TPKE 204
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City | RICHMOND
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State | VA
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Zip | 23235
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Country | US
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Telephone | 804-560-5439
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Fax | 804-560-5431
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Provider Business Mailing Address
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Address Line | 10043 MIDLOTHIAN TPKE FL 2
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23235-4856
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Country | US
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Telephone | 804-560-5430
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Fax | 804-560-5431
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Authorized Official
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Title or Position | VP OF OPERATIONS
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Name | TONYA MOORE
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Credential |
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Telephone | 804-560-5430
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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 | VA497735
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License Number State | VA
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