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General NPI Number Information
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NPI Number | 1619439544
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Entity Type | Organization
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Legal Business Name | SHANDS HOME CARE, LLC
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Dates
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Enumeration Date | 04/01/2019
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Last Update Date | 04/01/2019
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Provider Practice Location Address
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Address Line | 4601 STATION HOUSE RD STE 104
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City | CHESAPEAKE
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State | VA
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Zip | 23321-2511
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Country | US
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Telephone | 757-645-5595
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Fax |
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Provider Business Mailing Address
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Address Line | 6843 KENNY LN
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City | PORTSMOUTH
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State | VA
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Zip | 23703-2641
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Country | US
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Telephone | 757-645-5595
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MS. SHNAVIAN MONIQUE SHANDS
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Credential |
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Telephone | 757-645-5595
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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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