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General NPI Number Information
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NPI Number | 1609556687
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Entity Type | Organization
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Legal Business Name | MENDED PIECES HOME HEALTHCARE LLC
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Dates
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Enumeration Date | 07/24/2023
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Last Update Date | 07/24/2023
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Provider Practice Location Address
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Address Line | 1313 BALTIC ST
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City | SUFFOLK
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State | VA
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Zip | 23434-4140
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Country | US
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Telephone | 757-809-3155
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Fax |
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Provider Business Mailing Address
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Address Line | 1313 BALTIC ST
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City | SUFFOLK
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State | VA
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Zip | 23434-4140
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Country | US
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Telephone | 757-809-3155
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DEMETRIA YVETTE WILLIAMS
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Credential |
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Telephone | 757-809-3155
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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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