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General NPI Number Information
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NPI Number | 1588099527
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Entity Type | Organization
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Legal Business Name | TIMOTHY'S HAVENS LLC
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Dates
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Enumeration Date | 09/10/2013
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Last Update Date | 09/10/2013
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Provider Practice Location Address
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Address Line | 154 NEWTOWN RD SUITE B2-100
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-2406
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Country | US
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Telephone | 757-497-0925
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Fax | 757-497-0953
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Provider Business Mailing Address
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Address Line | 154 NEWTOWN RD SUITE B2-100
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-2406
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Country | US
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Telephone | 757-497-0925
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Fax | 757-497-0953
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. ANGEL FRANCENA GLASS
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Credential | BLS
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Telephone | 757-497-0925
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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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