=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467040469
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AFFIRMATION HOME HEALTH LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/05/2021
-----------------------------------------------------
Last Update Date | 02/23/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10124 W BROAD ST STE E
-----------------------------------------------------
City | GLEN ALLEN
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23060-3330
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-588-4944
-----------------------------------------------------
Fax | 804-510-2249
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10124 W BROAD ST STE E
-----------------------------------------------------
City | GLEN ALLEN
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23060-3330
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 804-588-4944
-----------------------------------------------------
Fax | 804-521-9204
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE CONSULTANT
-----------------------------------------------------
Name | FRANCESCA MUTERSPAW
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 804-588-4944
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------