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General NPI Number Information
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NPI Number | 1457665630
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Entity Type | Organization
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Legal Business Name | HEALTHCARE SERVICES 101
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Dates
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Enumeration Date | 07/30/2010
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Last Update Date | 07/30/2010
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Provider Practice Location Address
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Address Line | 204 E. WASHINGTON ST
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City | SUFFOLK
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State | VA
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Zip | 23434-4514
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Country | US
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Telephone | 757-809-3588
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5588
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City | SUFFOLK
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State | VA
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Zip | 23435-0588
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Country | US
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Telephone | 757-809-3588
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Fax | 757-809-3599
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Authorized Official
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Title or Position | CEO
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Name | MRS. RAQUEL MONTRELL HARRIS
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Credential | RN
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Telephone | 757-809-3588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 0001159829
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License Number State | VA
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