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General NPI Number Information
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NPI Number | 1407285992
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Entity Type | Organization
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Legal Business Name | LIFE'S AT HOME CARE LLC
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Dates
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Enumeration Date | 11/05/2013
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Last Update Date | 09/25/2018
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Provider Practice Location Address
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Address Line | 6763 BURBAGE LANDING CIR
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City | SUFFOLK
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State | VA
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Zip | 23435-3090
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Country | US
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Telephone | 757-535-2343
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Fax |
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Provider Business Mailing Address
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Address Line | 4601 STATION HOUSE RD STE 102
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City | CHESAPEAKE
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State | VA
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Zip | 23321-2511
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Country | US
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Telephone | 757-535-2343
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Fax | 757-251-0013
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | NICOLE DENISE DAVIS
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Credential |
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Telephone | 757-337-5160
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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 |
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License Number State |
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