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General NPI Number Information
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NPI Number | 1427598564
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Entity Type | Organization
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Legal Business Name | D'VINE HOME CARE LLC
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Dates
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Enumeration Date | 03/07/2017
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Last Update Date | 03/07/2017
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Provider Practice Location Address
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Address Line | 112 W WASHINGTON ST STE 602
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City | SUFFOLK
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State | VA
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Zip | 23434-5246
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Country | US
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Telephone | 757-539-0002
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Fax | 757-529-0012
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Provider Business Mailing Address
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Address Line | 112 W WASHINGTON ST STE 602
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City | SUFFOLK
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State | VA
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Zip | 23434-5246
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Country | US
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Telephone | 757-539-0002
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Fax | 757-529-0012
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ANGELE HILLARD
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Credential |
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Telephone | 757-237-2123
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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 | VA
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