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General NPI Number Information
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NPI Number | 1417461476
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Entity Type | Organization
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Legal Business Name | AT HOME CARE STAFFING - WILLIAMSBURG
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Dates
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Enumeration Date | 11/28/2017
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Last Update Date | 11/28/2017
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Provider Practice Location Address
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Address Line | 5501 DISCOVERY PARK BLVD STE 5
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-2952
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Country | US
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Telephone | 804-358-0631
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Fax | 804-612-3716
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Provider Business Mailing Address
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Address Line | 5700 OLD RICHMOND AVE STE D18
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City | RICHMOND
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State | VA
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Zip | 23226-1828
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Country | US
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Telephone | 804-358-0631
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Fax | 804-612-3716
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Authorized Official
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Title or Position | OFFICE MANAGER/ BOM
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Name | DORIS SANDERSON
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Credential |
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Telephone | 804-358-0631
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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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