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General NPI Number Information
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NPI Number | 1447793427
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Entity Type | Organization
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Legal Business Name | 360 HOME HEALTH
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Dates
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Enumeration Date | 11/23/2016
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Last Update Date | 11/23/2016
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Provider Practice Location Address
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Address Line | 6400 MECHANICSVILLE TPKE
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City | MECHANICSVILLE
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State | VA
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Zip | 23111-4579
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Country | US
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Telephone | 804-761-7351
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Fax |
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Provider Business Mailing Address
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Address Line | 290 THE LEVEL
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City | TAPPAHANNOCK
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State | VA
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Zip | 22560-5959
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | TAMIKA SHELTON
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Credential |
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Telephone | 804-761-7351
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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 | HCO-161323
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | HCO-161323
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | HCO-161323
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License Number State | VA
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